Chronic Wound Care

WHAT YOU SHOULD KNOW:

A wound is an injury that causes a break in the skin. There may also be damage to nearby tissues. Chronic wounds are wounds that do not heal completely in 6 weeks. Examples of wounds that can become chronic are deep ulcers (open sores), large burns, and infected cuts.

AFTER YOU LEAVE:

Medicines:

  • NSAIDs help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your primary healthcare provider (PHP) if NSAIDs are safe for you. Always read the medicine label and follow directions.

  • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

  • Antibiotics may be given to prevent or treat an infection caused by bacteria.

  • Take your medicine as directed. Contact your PHP if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your PHP as directed:

You need to return to have your wound checked. If you have packing in your wound, you need to return to have the packing replaced and the bandage changed. Write down your questions so you remember to ask them during your visits.

Wound care:

  • If your wound was closed with thin strips of medical tape, keep them clean and dry. The strips of medical tape will fall off on their own. Do not pull them off.

  • Keep the bandage clean and dry. Do not remove the bandage over your wound unless your PHP says it is okay.

  • Wash your hands before and after you take care of your wound to prevent infection.

  • Clean the wound as directed. If you cannot reach the wound, have someone help you.

  • If you have pain when you change your bandages, take pain medicine before you start.

  • If you have packing, make sure all the gauze used to pack the wound is taken out and replaced as directed. Keep track of how many gauze dressings are placed inside the wound.

Negative pressure wound therapy:

Negative pressure wound therapy (NPWT) is also called wound vacuum, or wound vac therapy. A vacuum device uses suction to remove fluid and waste from your wound and pull the edges closer together. It may also increase blood flow and new tissue growth in the wound. Your caregivers will decide if you need NPWT at home and how long you need it. Tell your caregivers if you do not feel able to use NPWT at home.

  • If you will use NPWT at home, get trained on how to use the equipment correctly. Ask your caregivers to watch you use the vacuum device to make sure you are using it correctly. Learn when and how to change the drainage container. Keep the directions in a place where you can find them easily.

  • Ask about the risks of NPWT, including bleeding and infection. Tell your caregivers about the medicines you use. Certain medicines, such as aspirin and blood thinners, increase your risk for bleeding. If you see blood in the tubing or container, or on your bandages, stop the device immediately. Apply direct pressure. Call 911 .

Eat healthy foods and drink liquids as directed:

Healthy foods give your body the nutrients it needs to heal your wound. Liquids prevent dehydration that can decrease the blood supply to your wound. Healthy foods include fruits, vegetables, grains (breads and cereals), dairy, and protein foods. Protein foods include meat, fish, nuts, and soy products. Protein, calories, vitamin C, and zinc help wounds heal. Ask for more information about the foods you should eat to improve healing.

Do not smoke:

If you smoke, it is never too late to quit. Smoking delays wound healing. Smoking also increases your risk for infection after surgery. Ask your PHP for information if you need help quitting.

Prevent pressure damage:

If you have a chronic wound, you may be at risk for pressure damage to your wound and other places on your body. Pressure sores can develop when blood flow to an area is blocked. For example, you sit or lie in the same position without moving and put pressure on your legs.

  • Prevent pressure sores by changing your position every 15 minutes while you are sitting. Prop your legs on pillows to lift your heels while you are lying down.

  • Check your skin daily for signs of pressure sores. Common signs are swelling, open sores, blisters, a rash, or changes in color or temperature. Tell your PHP if you have any of these signs.

Contact your PHP if:

  • You have a fever.

  • You have increased or new pain, swelling, redness, or bleeding in or around your wound.

  • You have pus or a foul odor coming from your wound.

  • Your skin itches or has a rash.

  • You have questions or concerns about your condition or care.

Seek care immediately or call 911 if:

  • You have muscle or joint pain, body aches, or sweating, with a fever.

  • You have a headache with diarrhea, nausea or vomiting, or a sore throat.

  • You are confused, or feel dizzy or faint when you stand up.

  • You have trouble breathing or sudden chest pain.

  • You see blood in the NPWT tubing or container, or on your bandages.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Chronic Wound Care (Discharge Care)

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