What is chronic open wound?
Most wounds heal in an orderly set of stages and in a predictable amount of time; those that do not are called chronic wounds. Wounds that do not heal within three months are considered chronic. Chronic wounds may never heal or may take years to do so. These wounds cause patients severe emotional and physical stress as well as creating a significant financial burden on patients.
Any wound, especially those on the feet where diabetic neuropathy may be present, should be of special concern to persons with diabetes. Neuropathy destroys nerves so that a person may be unaware that they have suffered an injury. Since those with neuropathy may also have circulation problems, even a tiny cut or blistered, unattended, may lead to infection and a chronic wound that may not heal. This may even result in amputation of part of the foot, entire foot, or even leg should gangrene result. As the population ages, and the number of diabetics is rapidly on the increase, the number of chronic wounds is expected to rise.
What are the types of Chronic Wounds?
The vast majority of chronic wounds can be classified into three categories:
- Venous ulcers
- Diabetic ulcers
- Pressure ulcers
Venous ulcers
Venous ulcers, which usually occur in the legs, exist in about 70% to 90% of chronic wounds and mostly affect the elderly. They are thought to be due to venous hypertension caused by improper function of valves that exist in the veins which exist to prevent backflow of blood. Ischemia results and, combined with reperfusion injury, causes the tissue damage that lead to the wounds.
Diabetic ulcers
Another major cause of chronic wounds, diabetes, is increasing in prevalence. Diabetics have higher risk for amputation than general population due to chronic ulcers. Diabetes causes neuropathy, which inhibits the perception of pain. Thus patients may not initially notice small wounds to legs and feet, and thus may fail to prevent infection and repeated injury. Further, diabetes causes immune compromise and damage to small blood vessels, preventing adequate oxygenation of tissue, which can cause chronic wounds.
Pressure ulcers
Another leading type of chronic wounds is pressure ulcers which usually occur in people with conditions such as paralysis that inhibit movement on areas that press against bones such as the heels, shoulder blades, and sacrum. Pressure ulcers are caused by ischemia that occurs when pressure on the tissue is greater than the pressure in capillaries, and thus restricts blood flow into the area.
Before treatment
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