What are non-healing wounds?
Treatment for non-healing wounds at Paik Vascular & Vein Center focuses on improving blood flow and addressing underlying issues that prevent the wound from healing. These wounds can occur due to poor circulation, diabetes, or other vascular problems.
First, we will assess the wound and your overall vascular health, often using imaging tests to evaluate blood flow. Depending on the findings, several treatment options may be recommended:
A common type of foot wound in patients with diabetes is related to abnormal pressure points on the skin and a lack of normal sensation that can lead to thick callus formation, and sometimes skin breakdown. If you don’t feel pain normally, you are more likely to develop a callus or a wound. “Pressure ulcers” will sometimes heal if the pressure is relieved; however, if the blood supply to the wound is not adequate, healing might not be possible, or it takes a very long time.
Treatment Options
Wound Care: Regular cleaning and dressing of the wound are crucial. Advanced dressings can promote a moist healing environment and protect against infection.
Debridement: This procedure involves removing dead or infected tissue from the wound to encourage healing.
Offloading: Reducing pressure on the ulcer through special shoes, casts, or braces helps facilitate healing.
Endovascular Treatments: If poor circulation is a factor, procedures like angioplasty or stenting can improve blood flow to the affected area, promoting healing.
Hyperbaric Oxygen Therapy: This therapy provides high-pressure oxygen to enhance healing and is especially useful for chronic ulcers.
Control of Blood Sugar: Tight management of diabetes is essential to promote wound healing and prevent further complications.
These wounds usually develop in the lower leg above the ankle. The wound depth is usually shallow, but can be deep. The wound oftentimes will have associated drainage or “weeping” of fluid. Stasis ulcers can occur in the setting of abnormal veins due to obstruction caused by blood clots or narrowing of the veins, or from leaky valves within the veins, which increases the pressure within the veins (venous reflux disease).
Treatment Options
Sclerotherapy: This minimally invasive procedure involves injecting a solution into affected veins, causing them to collapse and be absorbed by the body. It’s often used for spider veins and smaller varicose veins.
Endovenous Ablation: A catheter is inserted into the vein, and heat (laser or radiofrequency) is applied to seal the vein. This method is effective for larger varicose veins and is performed under local anesthesia.
Vein Stripping: This surgical procedure involves removing the affected vein through small incisions. It’s typically reserved for severe cases of varicose veins.
Compression Therapy: Wearing compression stockings helps improve blood flow in the legs and reduces swelling and discomfort.
Lifestyle Changes: Regular exercise, maintaining a healthy weight, and elevating the legs can help manage symptoms and prevent worsening of venous disease.
Arising from poor arterial circulation in the leg and foot, “Ischemic wounds” or areas of dying tissue – gangrene, are usually quite painful, especially when the foot is elevated while in bed. The pain might be relieved if the leg is dangled off the edge of the bed, or when the foot is on the floor, as gravity will pull blood down, bringing more oxygen into the tissues. For an ischemic wound to heal, the arterial blood supply must be improved to prevent extensive gangrene and potential limb loss.
Treatment Options
Lifestyle Modifications: Quitting smoking, eating a heart-healthy diet, and engaging in regular exercise can help improve overall vascular health.
Medications: Antiplatelet drugs (like aspirin) may be prescribed to prevent blood clots, and statins can help manage cholesterol levels.
Angioplasty and Stenting: A catheter is used to open narrowed arteries, often followed by placing a stent to keep the artery open.
Bypass Surgery: In severe cases, a bypass graft can be created to reroute blood flow around blocked arteries.
