Chronic wounds

Common signs include an open wound or sore that shows no improvement after four weeks, along with persistent pain, swelling, or warmth around the wound. Other features may include foul odour, excessive discharge, redness or breakdown of surrounding skin, fever, or signs of spreading infection.

Diagnosis begins with clinical assessment of wound size, depth, tissue condition, and discharge. A detailed medical history helps identify underlying conditions affecting healing. Wound swabs or tissue cultures detect infection and guide antibiotic selection. Doppler ultrasound assesses blood flow in the affected limb. When malignancy is suspected, a wound biopsy is performed to confirm the diagnosis.

Chronic wound treatment options include wound debridement, antimicrobial dressings, antibiotics, and compression therapy (for venous ulcers). Negative pressure wound therapy (NPWT) may also be used. Advanced therapies include skin grafting, platelet-rich plasma (PRP) therapy, and hyperbaric oxygen therapy.

Vascular and endovascular specialty at Manipal Hospitals, patients receive comprehensive non-healing wound care from the first consultation. A tailored treatment plan is developed based on wound type, underlying cause, and overall health.

Chronic wounds are managed using the TIME principle. Tissue debridement removes non-viable tissue. Infection control is achieved using antimicrobial dressings and appropriate therapy. Moisture balance supports healing, and edge management promotes proper wound closure.

Following this, the wound is assessed and classified, and investigations are performed to identify and address the underlying cause. Management of conditions such as diabetes or venous insufficiency is prioritised alongside local wound care.

Advanced procedures, including negative pressure wound therapy and skin grafting, are performed when required. Regular monitoring is carried out to track healing progress and adjust the treatment plan.

Dietary counselling and physiotherapy may be provided where necessary. Emotional support is also important, as chronic wounds can affect mobility, independence, and mental well-being. Early treatment helps prevent complications and improves quality of life.