Chronic wounds affect over 6.5 million people annually in the United States, with a total cost of over $26.8 billion per year.1 Proper identification of chronic wounds is necessary to develop an effective treatment plan, although many elements—such as intrinsic and extrinsic factors, comorbidities, and mixed etiologies—may complicate this process.2
When assessing a wound for chronicity, several factors should be taken into consideration, including:3
Wound chronicity is defined by the wound’s inability to progress through the repair cycle in a timely manner, and although there is no consensus for the time required for a wound to be labeled as chronic, a range of four weeks to three months is often cited.4 Generally speaking, when wound healing is impaired, there are multiple contributing factors. Non-healing wounds often display several similar characteristics, such as a high level of proteases, elevated inflammatory markers, reduced cellular proliferation, and low growth factor activity.5
Factors that commonly inhibit the healing process can include one or more of the following conditions:5
Common chronic wounds, as well as a brief overview of their characteristics, include the following:3
The best way to prevent wound chronicity is to control the risk factors, which is not always possible. When wound chronicity is suspected, an accurate and timely diagnosis is crucial to develop a treatment plan that will lead to proper healing. A comprehensive treatment plan will account for all of the factors and comorbidities that have an impact on healing, and regular monitoring will help to ensure that progress is being made.
1. Padula WV, Delarmente BA. The national cost of hospital-acquired pressure injuries in the United States. International Wound Journal. 2019.
2. Gupta S, Andersen C, Black J, et al. A compendium of clinical research and practice management of chronic sounds: diagnosis, preparation, treatment, and follow-up. WOUNDS. 2017. https://www.woundsource.com/resource/wounds-compendium-clinical-researc…. Accessed February 20, 2019.
3. Carver C. Chronic wound identification and assessment. WoundSource. 2018. from https://pages.woundsource.com/chronic-wound-identification-and-assessme… . Accessed February 20, 2019.
4. American College of Surgeons Division of Education. Non-healing wounds. ACS/ASE Medical Student Core Curriculum. https://www.facs.org/~/media/files/education/core%20curriculum/nonheali…. Accessed February 20, 2019.
5. Ucciolo L, Izzo V, Meloni M, et al. Non-healing foot ulcers in diabetic patients: general and local interfering conditions and management options with advanced wound dressings. J Wound Care. 2015;24(4), 35–42.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, HMP Global, its affiliates, or subsidiary companies.