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What to Do When Wounds Won't Heal Despite Proper Treatment




Proper wound healing depends on a lot of factors but none of them is more crucial than the kind of treatment one applies.


While most topical treatments are effective most of the time, there are instances when they aren’t. It is in these instances where further investigation is required to understand and find what could be causing the lack of progress.


Usually, the following factors need to be considered:


  • Moisture

  • Nutrition

  • Pain

  • Co-morbidities

  • Circulation

  • Blood glucose levels


If the above factors have already been managed but you still don’t see any signs of progress, it’s probably time to consider looking outside of the wound.


Proper diagnosis is essential before coming up with a treatment plan though. Otherwise, any treatment applied may not work.


That being said, below are a couple of tests to consider that will help determine the best way to treat a non-healing wound.


MRI or Bone Scan

This test will help rule out osteomyelitis in pressure ulcers. Once considered incurable, osteomyelitis is now considered treatable via surgery and antibiotics.


Albumin or Pre-Albumin Levels

The test can help indicate nutritional status as well as protein deficiencies. It can also help check for malnutrition, all of which can affect the wound healing process.


Tissue Biopsy

A tissue biopsy can help determine abnormal tissue growth, infection, or even cancer. Performed by a surgeon, the process involves tissue sample extraction that will help determine the presence and extent of a disease.


Arterial/Venous Dopplers

Arterial dopplers help detect possible blood flow blockages to the lower leg while venous dopplers can help identify the presence of deep vein thrombosis or DVT.


These tests are extremely important because blockages can easily lead to strokes if left undetected and untreated.


Hemoglobin A1C

This procedure is crucial to diabetic patients because it helps indicate long-term glucose control. It also helps determine if the diabetes management and medication the patient is taking is actually working or not.


Ultrasound Therapy

This procedure uses high-frequency sound waves that can help treat wounds and other forms of injury. It has been proven effective especially in addressing inflammation, pain reduction, and rapid wound healing.


Electrical Stimulation (ESTIM)

This procedure is performed by applying electrical current administered through electrodes that are placed on the skin either near or directly on the wound. It’s been shown to reduce infection, increase perfusion, improve cellular immunity, and accelerate wound healing, among others.


ESTIM is recommended for non-healing wounds that have remained unresponsive to standard wound care for at least 30 days. ESTIM is not recommended, however, in the presence of active bleeding, osteomyelitis, or if the patient uses a pacemaker.


Final Thoughts

Appropriate treatment is essential in achieving wound healing progress but as effective as basic topical wound treatments are, there are wounds that require more. This is why it’s important to closely monitor how wounds are healing because they can lead to more serious repercussions if left untreated.


The procedures mentioned should serve as alternatives in determining and establishing a suitable treatment plan for wounds that don’t heal as expected.


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