Chronic Wound Assessment and Treatment

Chronic wounds are those that did not heal within the expected time frame. Chronic wounds are also known as non-healing wounds affecting many the worldwide population.

Due to failure to complete wound healing, chronic wounds can greatly impact the quality of life because of anxiety, depression, financial burden, and social isolation.

The prevalence of chronic wounds worldwide led to the development of d treatment, extensive knowledge, and approach of wound healing for health care providers and wound care specialists to accurately treat and manage chronic wounds.

The below information aims to provide appropriate chronic wound care information to help assess and treat patients with chronic wounds.

Assessment of the patient’s general physical appearance

First is to conduct a thorough physical examination on the patient including the patient’s height, skin quality, and weight. Weight and height are factors to help primary care providers come up with appropriate nutritional management as nutrition is vital in the wound healing process.

Second is to check the skin color and see signs of erythema (redness of the skin). This must be done regardless of the patient’s skin color. But for dark-skinned patients, this can be done by checking the temperature and firmness of the skin around the wound.

Also, test the patient’s skin texture and elasticity by pulling up a fold of skin around the wound. If the skin tends to stand up like the tent position after you release it, it is an indication of dehydration.

Temperature. Check the temperature of the skin around the wound. Increased coldness or warmth is an indication of infection or impaired circulation.

Proper chronic wound care and assessment

  • Check precise wound location
    • Measure the wound’s circumference and depth and classify wound depth as partial thickness or full thickness.
    • Inspect and record signs of redness, swelling, or any skin discoloration within the 4cm perimeter of the wound area. Doing so allows your wound care specialist to apply appropriate wound care and treatment to prevent the spread of infection.
    • Inspect and document wound discharge; color, amount, and odor. Make a note of the discharge like none, minimal, moderate, or heavy while clear and watery, watery with a hint of pale red, or bloody for the wound drainage. Include documentation of odor from absent, moderate, or strong.
    • Lastly, ask the patient to describe the level of pain based on the standard pain scale in your chronic wound care center.

Chronic wound treatment

  • Clean the wound with saline solution before changing the dressing. If dressing is stuck to the wound, moisten it with the saline solution.
  • Once the wound is clean, it is often followed by removing dead tissue (if necessary) using a scalpel or tweezers, or high-pressure water jet, or using species of maggots for this purpose
  • Make sure to use the dressing that is appropriate to the wound type, appearance, and exudate. Some may use dressings with growth factors to promote the production of healthy body cells
  • Compression bandages may be used as well if the reason for the chronic wound is due to poor blood circulation. Compression stockings or bandages will help healthy blood flow for faster healing.
  • The use of antibiotics for chronic wound care depends on the severity of the wound.
  • Other treatments include hyperbaric oxygen therapy, ultrasound and electromagnetic therapy, Vacuum Assisted therapy, and skin grafts.

With proper chronic wound assessment and treatment, this promotes faster healing while decreasing morbidity at the same time improve the overall quality of life.