A non-healing wound is defined as a wound that has not healed or started to heal within 4 to 8 weeks. When a cut, burn, or wound is still persistent beyond one month, there are usually an underlying cause that needs to be treated. Typically, non-healing wounds occur in the lower extremities and are unresponsive to initial therapy. There are many types of non-healing wounds that may include venous, arterial, diabetic, pressure, and traumatic ulcers. The wound healing process is multifaceted and involves three phases: inflammation, tissue formation, and tissue remodeling. This process can become interrupted for multiple reasons and will cause a delay in wound healing and possibly lead to a chronic non-healing ulcer.
Chronic non-healing wounds are a major health problem, estimated to affect approximately 2-6 million people in the United States alone. Prevalence, worldwide, ranges from 1.9% to 13.1%. The incidence of chronic non-healing wounds is expected to increase as the population ages due to increased risk factors as smoking, obesity, and diabetes.
Wounds can occur for many different reasons. Regardless of the cause, if you are experiencing an abnormal wound, it is vital to seek treatment right away. If a wound is left untreated, you risk infection and possible loss of this appendage. There is also the risk of other medical complications such as organ failure, sepsis, or bone infection.
Diagnosing Non-Healing Wounds
Wounds can occur for many different reasons and can often heal on their own. If there is a wound that is not healing or if the patient is experiencing increasing pain, swelling or discoloration, fever or chills, oozing or bleeding, or a foul smell coming from the wound, a doctor should be notified.
Those with diabetes are at a particularly high risk of developing non-healing wounds due to elevated blood sugar levels. This can have a negative impact on circulation and weaken the immune system. Diabetic neuropathy can also cause nerve damage, making it easier for a wound to go unnoticed for a long period of time.
A normal healing wound, depending on the cause and type, will most likely be red, irritated, and even slightly swollen. A non-healing wound will have distinct symptoms. These include:
- Numbness in the area surrounding the wound
- Increased pain over time
- A change in the color of the wound
- An order
- Pronounced swelling
- A fever
- Discharge from the wound
- No signs of scabs or formation of new tissue
The goal of treating a non-healing wound would be wound closure as expeditiously as possible. There will need to be a customized plan to meet the needs of an individual wound. Conventional treatment for non-healing wounds includes wound cleansing, necrotic tissue debridement, prevention, diagnosis, treatment of infection, mechanical off-loading, and management of blood glucose levels. There is also a wide array of advanced treatments such as hyperbaric oxygen therapy, skin grafting, vacuum-assisted closure, and surgical management like angioplasty and reconstructive surgery. Issues of poor circulation, infection, edema, trauma to the wound, and malnutrition can be present in a multifactorial occurrence, and treatment of these underlying causes will be addressed by your doctor.
- Poor Circulation
- Bacteria on the skin or from other parts of the body
- Weakened Immune System
- Poor Nutrition
- Medical Conditions such as Diabetes
- Tobacco Use
- Excess Alcohol Consumption
- Advanced Age
- Being Overweight
Poor circulation can be caused by either venous insufficiency or arterial insufficiency. In venous insufficiency, blood and fluids cannot return up through the veins. This occurs when the valves inside the veins that prevent the backflow of fluids are not functioning properly. This will cause blood and fluids to pool in the lower extremities. To treat this, doctors will use compression therapy, including compression socks and bands, manual lymphatic drainage, and electronic sequential vasopneumatic pumps. With arterial insufficiency, plaque forms on the inside of the arteries and impedes blood flow. The most common way to treat his is through artery bypass or angioplasty.
Many factors not only affect the healing process but also can predispose a wound to become chronic and to developing complications such as infection. Appropriate cleansing, debridement practices, and choice of topical interventions are crucial steps that need to be taken to prevent a healing wound from becoming a non-healing wound. Removal of debris and foreign materials can help to reduce the risk of infection along with cleansing the wound with sterile saline or antimicrobial wound cleansers. Any foreign material that inhibits healing, such as toxins, bacteria, yeasts, or viruses, and also substances such as dressing residue, animal hair or dander, suture material, or any other types of debris, should be removed. Once a wound is debrided, multiple dressing formats can aid in inhibiting microbial proliferation, preventing infection, or treating local infection.
Majeraha yasiyoweza kupona ni yale ambayo hayajaanza kupona au kuisha ndani ya wiki nne hadi nane. Wakati kukatwa, kuchoma, au jeraha bado ni ya kudumu zaidi ya mwezi mmoja, kwa kawaida kuna sababu ya msingi ambayo inahitaji kutibiwa. Kwa kawaida, majeraha yasiyoweza kuponya hutokea katika viungo vya chini na hayakujibu matibabu ya awali. Kuna aina nyingi za majeraha yasiyoweza kuponya ambayo yaweza kutia ndani majeraha ya mishipa ya damu, mishipa ya damu, ya kisukari, ya shinikizo, na ya majeraha. Utaratibu wa kuponya majeraha una sehemu nyingi na unahusisha hatua tatu: uvimbe, kufanyizwa kwa tishu, na kurekebishwa kwa tishu. Utaratibu huu unaweza kuvunjwa kwa sababu nyingi na kusababisha kucheleweshwa kwa uponyaji wa jeraha na labda kusababisha kidonda cha muda mrefu kisichopona. Majeraha ya muda mrefu ambayo hayawezi kupona ni tatizo kubwa la afya, na inakadiriwa kuwa huathiri watu milioni 2 hadi 6 nchini Marekani pekee. Ugonjwa huo unaenea duniani kote, unafikia asilimia 1.9% hadi 13.1%. Matatizo ya majeraha ya muda mrefu yasiyoweza kupona yanatarajiwa kuongezeka kadiri idadi ya watu inavyozeeka kwa sababu ya kuongezeka kwa sababu za hatari kama vile kuvuta sigara, unene wa kupita kiasi, na ugonjwa wa kisukari. Majeraha yaweza kutokea kwa sababu nyingi tofauti. Bila kujali sababu, ikiwa una jeraha lisilo la kawaida, ni muhimu kutafuta matibabu mara moja. Ikiwa jeraha halitashughulikiwa, unaweza kuambukizwa na kupoteza sehemu hiyo. Pia kuna hatari ya matatizo mengine ya kitiba kama vile kushindwa kwa viungo, kuambukizwa kwa damu, au maambukizi ya mifupa. Majeraha yasiyoweza kupona yanaweza kutokea kwa sababu nyingi tofauti na mara nyingi yanaweza kupona yenyewe. Ikiwa kuna jeraha ambalo halipona au mgonjwa ana maumivu ya kuongezeka, uvimbe au mabadiliko ya rangi, homa au baridi, kuvuja au kutokwa na damu, au harufu mbaya kutoka kwa jeraha, daktari anapaswa kuarifiwa. Watu wenye ugonjwa wa kisukari wana hatari kubwa sana ya kupata majeraha yasiyoweza kuponya kwa sababu ya viwango vya sukari ya damu vilivyoinuka. Hilo laweza kuathiri vibaya mzunguko wa damu na kudhoofisha mfumo wa kinga. Ugonjwa wa neva wa kisukari pia waweza kusababisha uharibifu wa neva, na hivyo kufanya iwe rahisi kwa jeraha kutambuliwa kwa muda mrefu. Kwa kawaida jeraha linalopona, ikitegemea kisababishi na aina yake, laelekea litakuwa jekundu, litakasika, na hata kuvuja kidogo. Jeraha lisilopona litakuwa na dalili tofauti. Matokeo ya matibabu ni: - Ugonjwa wa maumivu ya kihisia, - Ugonjwa wa maumivu ya kihisia, - Ugonjwa wa maumivu ya kihisia, - Ugonjwa wa maumivu ya kihisia, - Ugonjwa wa maumivu ya kihisia, - Ugonjwa wa maumivu ya kihisia, - Ugonjwa wa maumivu ya kihisia, - Ugonjwa wa maumivu ya kihisia. Kutakuwa na mpango wa kibinafsi ili kukidhi mahitaji ya jeraha la mtu binafsi. Matibabu ya kawaida ya majeraha yasiyoweza kupona ni pamoja na kusafisha majeraha, kuondoa tishu za necrotic, kuzuia, kugundua, matibabu ya maambukizo, kuondoa mitambo, na usimamizi wa viwango vya sukari ya damu. Pia kuna aina mbalimbali za matibabu ya hali ya juu kama vile hyperbaric oksijeni tiba, ngozi grafting, utupu-msaidizi kufungwa, na usimamizi wa upasuaji kama angioplasty na upasuaji wa ujenzi. Matatizo ya damu, ugonjwa, uvimbe, majeraha ya kidonda, na utapiamlo yanaweza kuwapo katika tukio la multifactorial, na matibabu ya sababu hizi za msingi itashughulikiwa na daktari wako. - Mzunguko mbaya - Bakteria kwenye ngozi au sehemu nyingine za mwili - Mfumo wa kinga dhaifu - Lishe mbaya - Hali za matibabu kama vile Kisukari - Matumizi ya tumbaku - Matumizi ya pombe kupita kiasi - Umri wa hali ya juu - Uzito wa ziada Mzunguko mbaya unaweza kusababishwa na upungufu wa mishipa ya damu au upungufu wa mishipa. Katika upungufu wa mishipa ya damu, damu na umajimaji hauwezi kurudi juu kupitia mishipa ya damu. Hii hutokea wakati valves ndani ya mishipa ambayo kuzuia backflow ya kioevu si kazi vizuri. Hilo litasababisha damu na umajimaji kukusanyika katika viungo vya chini. Kwa matibabu ya ugonjwa huu, madaktari hutumia matibabu ya compression, ikiwa ni pamoja na soksi za compression na bendi, drainage ya lymphatic ya mkono, na pampu za elektroniki za vasopneumatic. Kwa kukosekana kwa mishipa ya damu, madoa hufanyizwa ndani ya mishipa ya damu na kuzuia mtiririko wa damu. Njia ya kawaida ya kutibu ugonjwa wake ni kupitia upasuaji wa kuondoa mishipa ya damu au upasuaji wa angioplasty. Kuna mambo mengi yanayoweza kuathiri mchakato wa uponyaji na pia yanaweza kusababisha jeraha kuwa la kudumu na kusababisha matatizo kama vile maambukizo. Utakaso sahihi, mazoea ya kuondoa bridges, na uchaguzi wa uingiliaji wa eneo ni hatua muhimu ambazo zinahitaji kuchukuliwa ili kuzuia jeraha la uponyaji kutoka kuwa jeraha lisilo la uponyaji. Kuondoa mabaki na vitu vya kigeni kunaweza kusaidia kupunguza hatari ya maambukizo pamoja na kusafisha jeraha kwa suluhisho la chumvi lisilo na sumu au dawa za kuondoa vimelea. Vitu vyovyote vya kigeni vinavyovuruga uponyaji, kama vile sumu, bakteria, chachu, au virusi, na pia vitu kama vile mabaki ya kuvalia, nywele za wanyama au manyoya, vifaa vya kushona, au aina nyingine yoyote ya mabaki, vinapaswa kuondolewa. Mara baada ya jeraha kuondolewa, aina nyingi za mavazi zaweza kusaidia kuzuia kuenea kwa vimelea, kuzuia maambukizo, au kutibu maambukizo ya mahali hapo.