Recalcitrant Wound

Becky Naughton's picture

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

I’m sure we’ve all hit that point in our wound care careers where we’ve had that one patient who’s wound just doesn’t seem to respond to any treatment. You’ve tried everything that you can think of—state-of-the-art dressings, advanced cellular products, regular debridement, and even hyperbaric oxygen. But despite all of this, the wound seems stuck. This is what’s known as a recalcitrant wound, a wound that fails to progress through the phases of wound healing in a typical timeline and becomes “stuck.” A wound that does not decrease in size by 30% in 3 weeks or by 50% in 4 to 5 weeks is considered recalcitrant. This is significant because wounds that don’t show improvement in size by 50% in 4 weeks have a 91% chance of not healing in 12 weeks.