By Johanna Graham, RN, NCC, WCC
Bumps, cuts and bruises are an inevitable part of everyday living, and no cause for great concern when we are young. For those over 60, however, minor skin tears can lead to complications that can become a great health threat if not properly treated.
Wounds that don’t heal, or at least improve, in six to eight weeks are considered to be chronic, and increase the risk of infection and further health complications.
Typical chronic wounds include pressure ulcers (also known as bed sores), wounds from complicated surgery and diabetic foot wounds. Conditions that are common underlying causes include diabetes, vascular diseases, edema of the lower extremities, loss of bowel/bladder function, or a weakened immune system; poor nutrition, steroid usage, and complicated surgeries can also contribute to skin breakdown that progress into chronic wounds. Common areas affected include the feet, ankles, heels and calves, as well as hips, thighs and buttocks on those who cannot walk.
The greatest risk from chronic wounds is infection. Bacterium that is commonly found around us can easily enter a wound, which can lead to serious conditions. Any time the surrounding tissue shows increased redness and warmth, there is increased pain, odor or drainage, immediate medical attention is required to be sure there is no infection.
There are many wound care centers and specialists in the medical profession today, all of which have expertise in caring for chronic wounds. A general practitioner is a good place to start, as he or she will be able to direct you to the appropriate discipline to best care for your wound. In a hospital or long-term care setting, staff members are specially-trained to handle common wounds in the patient population. Treatment may include medication and dressings, nutrition management, diabetes education, physical therapy, skin or tissue grafting, hyperbaric oxygen therapy and/or transcutaneous oximetry, which assesses the potential for wound complications.
If you are enlisted to care for the chronic wound of a family member or yourself, remember these guidelines to ensure safe and sanitary treatment:
•Always wash your hands before and after caring for any wound.
•Wear gloves whenever possible when caring for a chronic wound.
•Elevate legs if edema is present.
•Keep dressings clean and dry at all times.
•Work to offload the site from the pressure if the wound is the result of a pressure ulcer (i.e. if the wound is on a heel, elevate the foot so the heel is free from pressure).
•Report any noticeable changes to the doctor.
Chronic wounds can be both physically and emotionally stressful. Taking measures to prevent the wound in the first place, and regularly inspecting wounds to track the healing progress in those already experiencing skin breakdowns can go a long way to avoiding life-threatening complications.
Johanna is a Nursing Care Coordinator at Gurwin Jewish Nursing & Rehabilitation Center in Commack. She is also specially trained as a Wound Care nurse. For more information about the Gurwin Family of Healthcare Services, visit www.gurwin.org.
