Frequently Asked Questions about Wound Care

Rajeev Mysorekar, MD Program Director St. Johns Mercy Hyperbaric and Wound Treatment Center, St. Louis

What is a chronic wound?
A chronic wound is a wound that fails to progress through the normal stages of wound healing. It is as if these wounds have “forgotten” how to heal. The wound may be present for only a month, or may have been present for several years. Regardless of the type of wound, chronic wounds typically do not improve with routine treatment.

Why do chronic wounds fail to heal?
While much research is being done to answer this question, we know that there are some common reasons why chronic wounds fail to heal. One of the most important is lack of adequate blood flow to the wound. Infection within the wound and poor general nutrition are other important factors. Underlying illnesses, such as cancer or diabetes, can cause a general impairment in the body’s ability to heal wounds. Other reasons include a history of prior radiation exposure and unrelieved pressure on the wounded area.

What treatment options are available?
The treatment of chronic wounds is complex, often requiring the input of multiple trained specialists. In general, care of a chronic wound will involve treatment of underlying infection, removal of any dead tissue in the wound (debridement), and maximization of blood flow to the area of the wound. Adequate nutrition should be maintained, and the patient should stop smoking. If pressure is a causative factor, then that pressure must be relieved as much as possible. Other important issues include control of tissue swelling (edema), optimal glucose control for diabetics, and medical management of underlying chronic illnesses. If the wound does not heal with the above interventions, advanced therapies may be needed.  Examples of these superior options are bio-engineered tissue grafts or hyperbaric oxygen treatments. Very resistant wounds may eventually require surgical repair or reconstruction to achieve ultimate healing.

How do I prevent chronic wounds?
Most chronic wounds are easily preventable. In most cases, treatment of a chronic wound is much more difficult than preventing the wound from forming in the first place.  Wearing well-fitting, supportive footwear, for instance, will help prevent the formation of ulcers on the toes and foot. This is especially important for those people who have diabetes or vascular disease. People who are immobilized or bedridden as a result of stroke, spinal cord injury or advanced age can develop pressure ulcers (bedsores) on the buttocks, hips, heels, and other areas. Avoiding constant pressure through frequent turning and change of position – along with pressure-relief mattresses or cushions – can help prevent these problems. Proper nutrition, regular exercise, and avoidance of smoking can also help make the body more resistant to wound formation.

When should I seek help?
In general, a wound that is draining fluid, has a foul odor, or is very painful may be infected and requires medical attention. Other worrisome symptoms include fever and increasing swelling or redness around the wound. Of course, if you feel your wound is not improving, or if you have concerns about the appearance of your wound, you should seek medical assistance as soon as possible.

Where can I get help?
The St. John’s Mercy Hyperbaric and Wound Treatment Center provides comprehensive advanced wound care in a friendly outpatient setting. Our center utilizes the most current technology available to help your patients.  We offer a wide range of the most current topical therapies.  We also utilize bio-engineered wound therapies and can provide sharp debridements on site.

What are the goals of the center?
Our center uses a multidisciplinary approach to best meet the individual’s needs through:

• Diagnostic evaluation of the wound
• Development of a comprehensive treatment plan
• Patient teaching and interventional education
• Coordination of care with home health staff and referring physicians (both primary care and specialists)
• Prevention of further injury.

For more information, please contact us at 314-989-1181.