Multidisciplinary Care for Chronic and Non-Healing Wounds

Bacteria from infected tissue or an open wound can sometimes cause an infection in the bone. Symptoms vary greatly and can range from an open wound with exposed bone, to swelling, bone pain and lower extremity warmth and/or tenderness.

Our wound experts offer therapies and procedures to treat the infection and encourage healing of the wound to lessen the risk of further complications.

Serious, widespread burns require highly specialized care and are best treated at a dedicated burn center or trauma unit. After the initial healing however, the damaged tissues may be subject to the development of hard-to-heal wounds. This is when wound care experts can help with procedures and treatments to help prevent infection and promote healing. Treatment will often include debridement – the removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue.

Neuropathy is a condition caused by nerve damage or dysfunction and is characterized by weakness, numbness, tingling and pain, usually in the hands or feet. It often occurs in people with diabetes but it can also be caused by injuries and infections. As it worsens, neuropathy can lead to a total loss of sensation in the affected extremity.

Without sensations of pain, people with cuts or breaks in the skin – particularly in the feet – may be unaware of the injury. This can result in delayed treatment and lead to chronic wounds or ulcers that may be susceptible to complications like infection and gangrene.

Untreated, diabetic and neuropathic ulcers can become a severe health threat and may lead to a need for surgical amputation. Anyone with diabetes and/or peripheral neuropathy should examine their feet daily and consult their doctor immediately if there is any sign of skin damage or injury.

The lymphatic system is comprised of hundreds of lymph nodes found throughout the body, connected to each other by lymph vessels. The lymph nodes contain lymphocytes (white blood cells) that help the body fight infection and disease. The lymphatic system helps to maintain fluid levels in our body tissues by removing excess fluids that leak out of our blood vessels. If there is a problem with the lymphatic system, caused by obstruction, inflammation after trauma, cancer surgery to remove lymph nodes or radiation therapy, it can lead to excess fluid accumulating in an area of the body, usually an arm or a leg. The swelling that results is called lymphedema.

Chronic lymphedema can lead to many complications, including ulcers in the skin over the affected area due to inadequate drainage and blood flow and the resultant swelling (edema).Treatment will typically include appropriate dressing changes, compression therapy and elevation of the affected limb.

Pressure ulcers (also known as bedsores) are injuries to the skin and underlying tissue that occur when there is constant external pressure on any part of the body. The prolonged pressure reduces blood, oxygen and nutrients to the tissues, which can lead to open sores and, if untreated, tissue death. The most common locations for pressure ulcers are the lower back, buttocks, tail bone, heels and back of the head.

Pressure ulcers are most common in people confined to bed or a wheelchair for a long period of time. There are many complications that can develop if pressure ulcers are not promptly and effectively treated, including sepsis – a potentially life-threatening condition that occurs when the body's response to an infection causes widespread inflammation and damage to its own tissues.

The best treatment for pressure ulcers is prevention. Bedridden or wheelchair-bound people should be frequently turned or moved to avoid prolonged pressure on any one area of the body. If sores develop, they should be treated promptly by a wound care expert.

Radiation therapy is a highly effective and often-used treatment for many different types of cancer. Unfortunately, when the radiation kills the cancer cells it may also cause some damage to the healthy surrounding soft tissue. The radiated tissue has a reduced ability to heal, therefore the damage can persist for months or years if not properly treated. This condition is called soft tissue radionecrosis.

Wounds may develop at the site of treatment or in the nearby soft tissue that may have been damaged during the course of treatment. Wounds may also develop if there is minor trauma to the area or if a surgical incision is necessary on or near to the radiated tissue.

Vascular wounds occur as the result of decreased blood flow, particularly in the legs and feet. When blood flow is reduced, the tissues are deprived of oxygen and other nutrients, which ultimately results in tissue death and the formation of open wounds.

Also called ischemic ulcers or arterial ulcers, vascular wounds are typically slow to heal and, therefore, susceptible to infection. This type of wound is common in patients with a history of swelling in their legs, varicose veins and blood clots, any of which may be due to existing peripheral artery disease (PAD) or chronic venous insufficiency.