Treating chronic wounds by addressing their cause

A wound is generally described as chronic when it does not heal within four to twelve weeks despite treatment. These wounds commonly affect the foot or lower leg.

Pain, discharge, itching, odour or skin discolouration may occur. People with diabetic nerve damage may feel little pain even with a deep wound.

Common causes include reduced arterial circulation, venous disease, diabetes and persistent pressure. Duration, depth, wound edges, surrounding skin, pain and previous care are reviewed.

Compression can be important for venous wounds, but relevant arterial circulation problems must first be excluded.

Care may include cleaning, removal of dead or inflamed tissue and a suitable dressing. Selected deep or heavily discharging wounds may benefit from vacuum-assisted closure, known as VAC therapy.

The method and treatment setting depend on the wound's cause and condition. The underlying disease remains as important as local wound care.

Increasing redness, warmth, swelling, new pain, pus, unpleasant odour, fever or rapid deterioration needs prompt assessment. Call 112 for severe acute symptoms or signs of sepsis.