Chronic Wound Care

WHAT YOU SHOULD KNOW:

A wound is a type of injury where there is a break in the skin and may be nearby tissue damage. 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.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Wound treatment may be painful. Decreased blood supply to the area can lead to tissue death. Muscles, blood vessels, and bones may be affected. A scar may form on your skin as the wound heals. The risk of infection may increase with hydrotherapy (whirlpool treatment) or negative pressure wound therapy (NPWT). The risk of serious bleeding from the wound increases with NPWT.
  
  
• Without treatment, the wound may get larger or more painful, and it may get infected. Infection may spread to other parts of your body. Infection delays healing, and you may need surgery to treat it. Infection can damage a body part or function, and may even be life-threatening. Talk with your caregiver if you have questions or concerns about these risks or your treatment or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Tests:

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Wound culture: A wound culture is done to help caregivers learn more about your infection and decide the best medicine to treat it.
  
  
• X-ray: This is a picture of your bones and tissues in the wound area. You may need to have an x-ray if the wound is near a joint or bone. Caregivers look for broken bones, or objects such as glass or metal.

Medicines:

You may be given the following medicines:

• Medicines to treat pain, swelling, or fever: These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease or a history of bleeding in your stomach.
  
  
• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Creams or ointments: Caregivers may put medicines on your wound to help it heal.
  
  
• Anesthesia: Anesthesia is medicine used to decrease pain during a procedure. Caregivers will work with you to decide which anesthesia is best for you.

Wound dressings:

Dressings used for your wound may be in the form of bandages, gauze, films, gels, or foams. They are used to help your wound heal, and to protect it from further injury and infection. They may contain substances that help you heal faster. Elastic bandages may be used to give light pressure that helps to decrease swelling in tissues around the wound area.

Chronic wound treatments:

Treatment to improve and heal your chronic wound will depend on how severe your wound is, its location, and whether other areas are affected. It may also depend on the length of time you have had the injury. You may need any of the following:

• Cleansing: Caregivers flush the wound with sterile (germ-free) water. They may use a large syringe with a needle or catheter (tube) tip. They may also use a fluid that kills germs.
  
  
• Surgery:
  
  
  • Debridement: Debridement is done to remove things from the wound that can delay healing and lead to infection. These include dead tissue, objects such as small rocks, and dirt. Your caregiver will choose the best method of debridement for your wound. He may cut out the damaged areas in or around the wound. Caregivers may also drain the wound to clean out pus. Moist bandages may be placed inside the wound or bandages that contain enzymes may be used. Hydrotherapy (whirlpool treatment) uses water to mechanically clean wounds. You may need hydrotherapy to clean and debride burn wounds.
    
    
  • Skin substitute: Skin taken from another part of your body may be used to close a large wound. Caregivers may instead use artificial skin that contains cells needed to repair damaged tissues.
  
  
• Negative pressure wound therapy: Your caregiver will decide if you need negative pressure wound therapy (NPWT). This therapy 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. This therapy may also help your wound heal by increasing blood flow and new tissue growth in the wound.
  
  
• Hyperbaric oxygen therapy: This is also called HBO. HBO is used to get more oxygen into your body. The oxygen is given under pressure to help it get into your tissues and blood. You may be put into a tube-like chamber called a hyperbaric or pressure chamber. You will be able to see your caregivers and talk with them through a speaker. You may need to have this therapy more than once.

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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 (Inpatient Care)