There are many reasons why a wound won’t heal, let’s take a look at the most common ones. A wound is considered “non healing” or “chronic” if it has not healed significantly in 4 weeks or completely in 8 weeks. Some wounds can stay around for months and will not heal without medical intervention. Chronic wounds of all different kinds do have some common denominators like no development of a scab or new tissue within 30 days, numbness around the wound, discharge or foul odor, change in color, or swelling. Non healing wounds are an indicator something else is the underlying cause. 

One of the more common causes is infection. Our skin is covered in bacteria which is considered normal flora for the body but a tiny break in the skin can be enough for it to cause an infection. The wound will be red, swollen, possibly draining, hot to the touch, there may be red streaks coming from the wound visible on the skin. Antibiotics and/or wound care will aid in healing an infected wound. 

Impaired circulation creates problems in getting wounds to heal and patients who suffer from this can experience different symptoms and be challenging to treat. Poor blood flow can also be a cause of chronic edema and a break in the skin can allow clear fluid to leak out of the skin. Compression stockings or wraps and elevation are the most effective treatments for wounds that are being caused by poor venous blood flow and edema. This means the blood is trapped in the lower legs and unable to return to the heart and lungs. Elevating the legs higher than the torso, even for 30 minutes several times a day can improve chronic edema. Keeping sodium intake to a minimum and eating a high protein diet can also be helpful.  

Poor circulation coming from arterial blood flow issues is a more complicated problem and may sometimes require emergency surgery if there is a blockage. These patients should be very cautious with compression as the flow of blood carrying oxygen to the tissues is already compromised. Feet that are always cold, bluish or purple, sometimes swollen, painful when they are elevated can all be signs of poor arterial flow. A toe or area that appears white or dark purple can be a sign of an arterial blockage and needs immediate treatment. Uncontrolled diabetes is one of the most common causes of arterial damage. 

Pressure wounds or bed sores can develop quickly when a patient is unable to move properly or just spends lots of time in one position. Patients may be unaware of the development of these wounds especially if they lack sensation from a spinal cord injury. Good skin care and regular assessments of areas prone to breakdown are important. Maintaining as much mobility as possible and changing positions frequently will help prevent them from starting. 

Talk to your doctor if you have any wounds that do not heal within 30 days so you can explore the reasons why together.