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Treating Chronic Wounds Thu Aug 11, 2011 4:34 am
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Treating Chronic Wounds


For most people, a minor wound -- a blister from a new pair of shoes, for instance -- is nothing to worry about. It hurts and then goes away. But for some, sores or cuts just won't heal -- for months or even years. High blood sugar, circulation problems, smoking, peripheral neuropathy, aging, and malnutrition can all cause long-lasting wounds that don't heal.

"Chronic wounds are an awful and underappreciated problem," says Gerald Lazarus MD, director of the Johns Hopkins Wound Center and chief of dermatology at the Johns Hopkins Bayview Medical Center in Baltimore. "They're painful, ugly, and debilitating."

They can be socially isolating too. People are often ashamed of how the wounds look and -- in some cases -- how they smell, Lazarus says. Chronic wounds are also a sign of a potentially serious underlying condition that needs treatment.

Up to 2% of people in the U.S. have chronic wounds. If you have a wound that just won't heal, it's not enough to bandage it every day and hope it goes away. You need help. Here's what you should know about healing a chronic wound.

What Causes Chronic Wounds? Doctors consider any sore that doesn't heal within six weeks to be a chronic wound. Although the wound clearly needs medical care itself, it's really a symptom of deeper health issue, Lazarus says.

"Healthy people don't get chronic wounds," Lazarus says. "You need to discover and treat the underlying problem that's causing them."

Some of the most common include:

Chronic venous insufficiency, diabetes, and other circulation problems. For a wound to heal well, it needs good blood flow. Chronic venous insufficiency -- a circulation problem in which blood tends to accumulate in the veins of the legs -- causes about 60% of all chronic wounds. Diabetes also causes poor circulation, and it's another leading cause of chronic wounds, Lazarus says. People with diabetes may have nerve damage in their feet that prevents them from feeling an injury. Plaque in the arteries -- atherosclerosis -- can also cut off blood supply, causing wounds that don't heal. Pressure. In people who are in a bed or wheelchair, pressure ulcers, or bedsores, are a common problem. Since the pressure never lets up, the wound never gets a chance to heal. "I've met people who are paraplegic who tell me that they've almost come to grips with their condition," says Lazarus. "[But] what they're really worn out by is dealing with this awful, messy wound that won't heal." Surgery or radiation treatment. Surgery or radiation treatment for cancer can sometimes cause lasting damage to the skin that won't heal. Other health problems. Many conditions -- ranging from bowel disease to rheumatologic problems such as lupus -- can contribute to chronic wounds. Other factors can play a role in chronic wounds. The overuse of antibiotics, allergic reactions to wound dressings, and common drugs such as corticosteroids and NSAID pain relievers can affect wound healing.

Lazarus says that chronic wounds are a serious and growing concern in the U.S. Why? "I think the rise in obesity is the biggest problem," he tells WebMD. Obesity is related to the growth in diabetes. It also makes conditions such as chronic venous insufficiency worse.

http://www.webmd.com/a-to-z-guides/wound-care-10/treating-chronic-wounds?src=RSS_PUBLIC
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Treating Chronic Wounds Thu Aug 11, 2011 4:34 am
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