People living with chronic wounds typically have other medical conditions that affect their everyday life. Congestive heart failure and diabetes are just two examples, as are any diseases that may keep them bedridden or wheelchair-bound. People with ulcers and chronic wounds can face many challenges, including:

• Pain
• Altered or limited mobility
• Sleep disorders
• Difficulties maintaining body hygiene
• Depression
• Low self-esteem
• Feelings of frustration
• Social isolation

For these reasons, a chronic wound or ulcer can be psychologically stressful for a person as well as for their families, friends and caregivers. For the person with the condition, they may have thoughts and feelings about:

• Having a low level of control over their condition
• Being unable to predict how long and how severe their wound will be
• Seeing the wound as proof that things are getting worse or that they are “falling apart”
• Having few outlets for their frustration
• Not having enough social support

In spite of these challenges, many people do adjust to living with a chronic wound. Those people who do best tend to do one or all of the following:

• Cope by comparison—that is, they emphasize the positive aspects of their own lives compared with those less fortunate
• Focus on feeling healthy in spite of the wound
• View the condition as part of the ageing process and adjust their expectations accordingly
• Simply be positive

If you have a chronic wound or are at risk for a chronic wound, you can help yourself by doing the following:

Venous leg ulcer:

• Wear your stockings every day
• Exercise regularly. Walking is all it takes, as compression bandages and stockings work best when you move. If you are less mobile, exercise your leg muscles by moving your foot up and down at the ankle
• When you sit, keep your legs raised by putting your feet on a stool or chair

Diabetic foot ulcer:

• Check your feet regularly for small cuts and sores. These can grow into large wounds. Use a mirror or ask your partner to help if you can’t see the bottoms of your feet
• If you already have a wound on your foot, see your doctor about special footwear to take the pressure off the spot. Don’t continue to walk on the wound, even if you can’t feel pain

Pressure ulcer:

• Remove the source of pressure from the affected area. If you lack the mobility or strength to do so, have someone help you adjust your position frequently

All types:

• If you smoke, stop
• Eat a healthy, balanced diet. If you’re overweight, do what you can to lose weight
• Ask your doctor for a referral to a wound-care specialist

 People with chronic wounds or leg ulcers can find additional support online. The Canadian Association of Wound Care has information and resources that can help.

If you suspect you have a chronic wound or a developing ulcer, seek medical care immediately, particularly if you have any of the following conditions:

• Diabetes
• Arterial disease
• Chronic edema (swelling) of the lower extremities
• A family history of collagen vascular disease, such as scleroderma or rheumatoid arthritis

In addition, a slow-healing wound may indicate an infection or other significant problem that is affecting the whole body.

Treatment for chronic wounds take time. The goals of treatment are usually to:

• Keep the wound infection-free
• Absorb any excess discharge
• Keep the wound clear of dead tissue, usually through debridement (removal of tissue)
• Maintain a moist wound environment
• Supply compression to control the edema (swelling) in the case of venous stasis ulcers
• Manage pain
• Offload pressure from the affected area (for diabetic foot and pressure ulcers)
• Promote more activity to increase circulation
• Manage the person’s medical issues

Your doctor will prescribe the course of therapy that is best for your type of wound.

Other steps you can take to promote healing include:

• Ensuring you eat an adequate, well-balanced diet
• Losing weight if necessary
• Stopping smoking (smoking impairs circulation)

*All information on medical treatments on this site is provided as an overview only. For a complete and up-to-date list of side effects, warnings and precautions, read the product’s package insert and consult your doctor or a pharmacist.
**If you are considering an alternative or complementary therapy, discuss it with your doctor first, and always be sure to keep your doctor up to date about any vitamins, supplements, or other forms of alternative treatment you are taking. Like any medication, alternative therapies can interact with other medications/treatments and, in some cases, have side effects of their own. Remember that “natural” does not necessarily mean “safe.”

The information in this section has been gathered from existing peer-reviewed and other literature and has been reviewed by expert dermatologists on the CSPA Medical Advisory Board.

Chronic wounds/ulcers are open areas of the skin that do not heal despite weeks of careful treatment. And even when these wounds are successfully treated, they tend to recur.

Acute wounds typically heal in one to three weeks in a dynamic process that restores the integrity and function of the skin and the underlying tissue. If a wound does not heal in four to 12 weeks, it is considered chronic. With any wound, natural healing occurs in clearly defined stages, but chronic wounds get stuck at one of the stages and cannot get past it.

Causes

Chronic wounds and ulcers are caused by poor circulation, either through cardiovascular issues or external pressure from a bed or wheelchair. People affected by chronic wounds are typically sedentary, often bedridden, wheelchair-bound and/or have diabetes. Good circulation requires regular bodily movement such as going for a walk. Chronic wound types include:

• Pressure ulcers (also known as bed sores)
• Diabetic foot ulcers
• Leg ulcers (venous stasis and arterial ulcers)
• Ulcers resulting from blood disorders

skin ulcer 1

A chronic wound is a wound that does not progress toward closure in a timely manner. The typical signs of a chronic wound include:

• Pain (except in many cases of diabetic foot ulcer, where there is no sensation at all)
• Erythema (inflammation or redness of the skin)
• Edema (swelling)
• Heat
• Purulence (the presence of pus)