August 31, 2020

Why You Shouldn’t Ignore a Wound That Won’t Heal

Three common causes of chronic wounds

wrapping wound on arm

If you have a sore or wound that lingers over a period of weeks or months, it’s time to see your doctor. A chronic wound can lead to dangerous complications, but there are a number of treatment options to help avoid more serious problems.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Chronic wounds, by definition, are sores that don’t heal within about three months. They can start small, as a pimple or a scratch. They might scab over again and again, but they don’t get better.

If you have a sore or wound that follows this pattern, it’s a red flag that you should consult a physician to start a care plan, says plastic surgeon Christi Cavaliere, MD, Medical Director of Wound Care.

“A comprehensive approach is really what makes the difference in getting healed,” she says. “So, people must get the comprehensive care they need from a primary care physician, a plastic surgeon, a podiatrist, a vascular surgeon or a wound center.”

Why isn’t my wound getting better?

While cancer can sometimes present as a chronic wound, chronic wounds typically fall into three main categories: diabetes-related ulcers, venous leg ulcers and pressure ulcers.

1. Diabetes-related ulcers (previously known as diabetic ulcers)

People who have diabetes are at greater risk for chronic wounds. Several factors contribute to this, including:

Advertisement
  • Neuropathy: Loss of feeling in the feet makes it more likely that small cuts or trauma will go unnoticed, leaving wounds at risk for infection.
  • Poor blood flow: Insufficient blood flow to the legs makes it harder for wounds to heal.
  • Infection: Compromised ability to fight infection puts people with diabetes at greater risk for wounds that progressively worsen and may require amputation.

To control chronic wounds, people with diabetes should make sure they’re eating enough protein, hydrating properly and maintaining control of their blood sugar levels. It is also important to wear shoes that don’t create sores and keep toenails cut short.

Anyone who has diabetes should seek medical attention for any foot wound as soon as possible. “It can’t wait,” Dr. Cavaliere says. “The stakes are too high, and you need to make sure any infection is addressed.”

2. Venous leg ulcers

Venous leg ulcers account for a high percentage of leg wounds. Frequently, they stem from uncontrolled swelling in the legs and tend to weep because the legs are overfilled with fluid. They can also be painful and itchy. Blood doesn’t flow back up the legs well with these wounds, so the legs often feel heavy. The skin around the wound can harden and become discolored.

Venous leg ulcers tend to recur, and maintenance usually requires regular compression therapy such as compression stockings. Any leg swelling should be evaluated by a healthcare professional, because many conditions cause swelling. Some, such as blood clots, require more extensive evaluation or treatment.

Treatment options for venous ulcers may include:

Advertisement
  • Compression garments: ACE bandages or compression stockings help prevent fluid from pooling in the legs and can stave off future leg ulcers.
  • Vascular intervention: A vascular surgeon can help identify what underlying cause is contributing to leg ulcers.

3. Pressure ulcers

These wounds occur when pressure is constantly exerted on body tissue over a period of time. The constant pressure compresses vessels that carry blood to keep the tissue alive, opening the door for injury, Dr. Cavaliere says.

People who are bed-bound or use a wheelchair are at highest risk for pressure ulcers, including those with spinal cord injuries or those with some form of dementia. Sores are most likely to develop on the tail bone, sacral bone or heels.

“Unrelieved pressure can lead to full-thickness tissue death, leaving large wounds and, potentially, exposed bone,” Dr. Cavaliere says.

The No. 1 treatment for pressure ulcers is simply removing the pressure. Turning or moving the body can prevent injury. Some patients may also require special mattresses or additional cushioning to protect bones. Untreated ulcers can develop into infections so severe that hospitalization and intravenous antibiotics are required.

Related Articles

Notes taped to window of possible new year's resolutions with hand in foreground holding marker.
December 1, 2023
How To Keep Your New Year’s Resolutions

Pick specific, measurable goals, but also be open to changing them if need be

person holding a thermometer with stress thought bubbles above head
December 1, 2023
Yes, There Is Such a Thing as Stress Sickness

From nausea, weight gain and eczema, stress can affect your immune system in many ways

bowl of soy-based cubes with hand
November 30, 2023
Can Soy Cause Breast Cancer?

Research consistently shows that soy-based foods do not increase cancer risk

person scratching neck that has eczema
November 29, 2023
How Lifestyle Changes and Self-Care Can Improve Your Atopic Dermatitis

Changing your wardrobe or environment won’t eliminate eczema, but it can help reduce flares

person stressing, with clock and books
November 29, 2023
6 Ways To Feel Less Anxious in the Mornings

Breathwork, sleep mediatation and avoiding screens can help fight back morning anxiety

covid toe
November 28, 2023
Are COVID Toes and Rashes Common Symptoms of the Coronavirus?

Chilblain-like skin lesions and rashes probably aren’t COVID related

magnesium pills out of container spelling out MG
November 28, 2023
Magnesium for Anxiety: Does It Help?

This supplement may help with regulating cortisol levels, which may help with stress

woman in her forties, using an inhaler
November 28, 2023
Why Sex Hormones Can Help (or Hurt) Your Asthma

Developmental changes like puberty and menopause can impact symptom severity

Trending Topics

group of hands holding different beverages
November 14, 2023
10 Myths About Drinking Alcohol You Should Stop Repeating

Coffee won’t cure a hangover and you definitely shouldn’t mix your cocktail with an energy drink

Person applies moisturizer as part of their skin care routine after a shower.
November 10, 2023
Korean Skin Care Routines: What You Need To Know

Focus on the philosophy — replenishing and respecting your skin — not necessarily the steps

glass of cherry juice with cherries on table
November 8, 2023
Sleepy Girl Mocktail: What’s in It and Does It Really Make You Sleep Better?

This social media sleep hack with tart cherry juice and magnesium could be worth a try

Ad