chronic wound care and management

Chronic Wound Management: Learning the Basics

A chronic wound can cause a great deal of pain, discomfort and even debilitation for a patient. Whether it’s a venous stasis ulcer, a bed sore or a non-closing surgical incision, chronic wound care and management is essential to promote faster healing and help the patient get back to their quality of life.


To understand chronic wound care management, it’s important to learn the basics first:



What Is the Pathophysiology of Chronic Wounds?


Any type of wound will undergo the four phases of the healing process: hemostasis, inflammation, proliferation and remodeling. This usually happens within a specific time period depending on the severity of the wound and the overall health condition of the patient. A wound can be classified as chronic when it fails to heal within that reasonable time period, which is usually three months.



Several factors affect the chronicity of a wound including increased bacterial load, pressure or trauma, degraded growth factors and cell surface structures and of course, inappropriate treatment. The first step to proper chronic wound care is to do a full assessment of the patient and identify the causes of the wound’s chronicity.




What Are some Things to Check During Chronic Wound Assessment?


Wound assessment begins with locating the anatomic location of the wound since it’s important in creating a proper wound care plan. The wound should be measured for circumference and depth and classified as partial-thickness or a full-thickness wound. Other things to assess include its surrounding skin and tissue, the appearance of the wound-bed tissues, its exudate, edges and undermining and tracts. It’s also very important to take note of the patient’s pain level and discomfort so proper pain management can be included in the plan.




What are Some of the Steps to Chronic Wound Care?



Preparing the Wound


Wound preparation is critical for removing the hindrances to healing. Controlling bio-burden or the microbes that contribute to poor healing starts with cleaning the wound using a non-cytotoxic agent. Debridement follows to remove necrotic tissue and slough within the wound bed. To maintain moisture balance within the wound, proper dressing must be applied. This keeps the wound bed moist and exudates are managed to avoid the growth of microbes.



Choosing a Dressing


Factors such as appearance, exudate and pain need to be considered when choosing the right dressing for a chronic wound. Hydrogel dressing is applied for wounds that need extra moisture, a non-adherent dressing is ideal to avoid painful tearing and alginate dressing is used primarily for deep wounds.




To ensure good healing, it’s very important to re-assess the patient’s wound on a weekly basis to see if the chronic wound care plan worked. If there isn’t any progress, adjustments can be made quickly to ease the burden of the patient.




At the end of the day, proper chronic wound care and management is a collaborative effort between the health care provider and the patient. So, make sure that you work together in coming up with strategies that will help you achieve the common goal of full wound healing.




We specialize in diagnosis and treatment for any and all wound care issues for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment, please contact us.