Most wounds heal in a predictable sequence: the body stops the bleeding, clears away damaged tissue and infection, rebuilds tissue, and closes the skin. A chronic wound is one that gets stuck somewhere in that process, often for weeks or months.
Chronic wounds frequently have more than one cause. A person may have several health conditions at once, and those conditions can overlap in ways that keep a wound from closing.
It is estimated that 1–2% of people in the United States will have a chronic wound at some point in their life. Because a chronic wound can affect comfort, mobility, and independence, understanding what type of wound you have, and what is driving it, is an important first step.
Types of Chronic Wounds
Arterial Wounds
Arterial wounds happen when blood flow to an area is reduced. Without enough circulation, tissue does not receive the oxygen and nutrients it needs to repair itself, and even a small injury may fail to heal. They often begin as a wound that simply never closes.
Venous Wounds
Venous wounds are related to swelling, or edema, in the leg. When blood does not return efficiently from the legs to the heart, pressure and fluid build up in the tissues and can break the skin down. They commonly appear along the inside of the ankle.
Neuropathic (Diabetic) Wounds
Neuropathic wounds are often called diabetic wounds, because diabetes is the most common cause of the nerve damage behind them. When sensation is reduced, repeated small injuries and pressure points can go unnoticed, especially on the bottom of the foot, and develop into an ulcer. Diabetic foot ulcers are a leading cause of non-traumatic amputations, which is why routine diabetic foot care and early attention to any wound matter so much.
Pressure Injuries
Pressure injuries, sometimes called bedsores, are damage to the skin and underlying tissue caused by prolonged pressure. They most often form over areas where bone sits close to the skin, such as the tailbone, hips, heels, and ankles. Moisture, friction, and the reduced circulation caused by pressure can all contribute.
Other Causes
Some chronic wounds develop because of another systemic condition, such as gout or an inflammatory disease. In rare cases, what appears to be a chronic wound can be a sign of cancer. That is one reason a wound that does not heal deserves a careful evaluation.
Why the Type Matters
Identifying the type of wound, and the factors contributing to it, guides treatment. A wound related to poor circulation needs a different approach than one caused by pressure or nerve damage. Many people have more than one contributing factor, so a thorough evaluation looks at the wound itself along with circulation, pressure, sensation, infection, blood sugar, nutrition, and overall health.
When to Seek Care
Consider an evaluation for a wound that is slow to heal, recurring, or showing signs of infection. Preventive foot checks and early treatment are especially important for people with diabetes or reduced circulation.
Learn about Wound Care at Rochester Clinic.