Periwound

The management of wounds, especially complex and chronic wounds, is a daunting clinical challenge. Achieving progress toward wound closure often depends on the right selection of treatment modalities for the wound and acknowledgment of any other underlying clinical considerations that present barriers to healing. However, before treatment selection, a full and accurate wound assessment must be completed. Without analyzing all variables that impact wound healing, clinicians may be unable to identify the proper treatment course.

By Becky Naughton, RN, MSN, FNP-C, WCC

In Part 1 of this series on recalcitrant wounds, we started our discussion on some factors on why wounds may seem to stall or stop healing. It can be very difficult in trying to treat a wound that seems to resist all efforts to get it to heal. In Part 1, we discussed some signs of a recalcitrant wound, exploring alternative etiologies behind a wound and how dressings can impact a wound’s ability to heal. In Part 2, we will discuss other possible factors that can cause a recalcitrant wound, including, infection, prolonged or chronic inflammation, the presence of necrotic tissue, the edge effect, nutrition as well as socio-economic factors. We must also bring up the fact that, due to underlying comorbidities or complications, some wounds may never heal and how to start a conversation about this.