Chronic Wound Care (Pressure Sores, Venous Ulcers and Diabetic Feet)
Chronic wound care requires a multi-disciplinary approach. In Chronic Wound Care Polyclinic, doctors and other medical professionals examine and assess the patient’s wounds and decide the most appropriate way of treatment. Not only care and dressings are arranged according to the wound characteristics, but also Plastic Surgery and General Surgery divisions closely follow up the patient again according to the wound characteristics. For wound care, imported “Wound Care and Dressing Materials” are used. Our specialized doctors determine the control periods and take necessary actions according to situation and needs of the patient.
What is chronic wound?
Wounds which heal late or difficultly or do not heal at all are called “chronic wounds”. Differently from acute wounds, chronic wounds have their specific characteristics. Ischemia, hypoxia or infection are basic characteristics of chronic wounds. If a wound does not heal in three months, it is termed as chronic wound. Included among chronic wounds are diabetic foot wounds, pressure sores, venous ulcers, ischemic ulcers and wounds associated with various vasculitis. Chronic wounds may develop also due to soft tissue radionecrosis developing as a result of radiotherapy to soft tissue areas, and due to extravasation (leakage or discharge of fluid from a vessel into tissue spaces) of some chemotherapy drugs.
General factors leading to chronic wounds are obesity, smoking, malnutrition, advanced age, vitamin and trace element deficiencies, malignity, chemotherapy and radiotherapy, use of immunosuppressive drugs, use of steroids and anticoagulants. However, a wound may become chronic even without general factors. In this case, we rather mention about local factors affecting the wound site. Insufficient blood flow, excessive tension of skin, inappropriate closure of surgical wounds, insufficient venous drainage, presence of a foreign object, presence of infection, mobility of wound site and similar other local factors may delay the wound healing.
Types of chronic wounds:
Wounds which do not heal in a certain period of time and generally recur are called “chronic wounds”. These wounds may be defined as a visual proof of such an underlying cause as a pressure on tissues, weak blood circulation or poor nutrition. Pressure sores, venous leg ulcers and diabetic foot may be shown as examples of chronic wounds. For a successful treatment of chronic wounds, the patient must be examined as a whole. In addition, very careful wound care, understanding of wound healing process, knowledge about modern wound dresses and intervention with and control of underlying causes of wound are also required.
Diabetic Wounds (Wounds in diabetic patients):
Diabetes, being a chronic disease, causes damages to vascular and nerve tissues by time. Circulation disorders in vessels cause wounds particularly in feet. As the wounds are recognized late, wound care takes a long time. For treatment of wound, it is required to keep blood glucose under control, and to hold the wounded foot above the heart elevation, and to perform appropriate wound care and dressing depending on wound characteristics such as infection and necrotic tissues. Treatment takes a long time and requires patience. Sometimes, regression may be reported in the course of wound healing in spite of application of the required wound care.
Diabetic Wounds (Wounds in diabetic patients): Diabetes, being a chronic disease, causes damages to vascular and nerve tissues by time. Circulation disorders in vessels cause wounds particularly in feet. As the wounds are recognized late, wound care takes a long time. For treatment of wound, it is required to keep blood glucose under control, and to hold the wounded foot above the heart elevation, and to perform appropriate wound care and dressing depending on wound characteristics such as infection and necrotic tissues. Treatment takes a long time and requires patience. Sometimes, regression may be reported in the course of wound healing in spite of application of the required wound care. Wounds Due to Circulation Disorders: Circulation disorder diseases such as Burger disease and arteriosclerosis associated with smoking cause occlusion of vessels. Vascular occlusion leads to leg wounds, and in advanced cases, loss of foot and leg. In this type of diseases, wounds are generally deep and require a long-time therapy. Varicose Wounds: These wounds are mostly seen in front of leg and in ankles, and basic reason thereof is blood circulation problems caused by advanced varicose. Treatment of varicose wounds is difficult, and requires consultation of patient to a specialized doctor. These wounds should be followed up under control of a doctor, and should be treated in accordance with the wound. It should be kept under doctor control, and dressing fit to wound should be applied, and if deemed necessary, surgical intervention should be applied. Pressure Sores: Wounds caused by pressure on points of contact with bed or wheelchair due to use of wheelchair or due to long-time lying on the same position for bed-ridden / paralytic patients. The pressure emerges as redness and if not treated, may turn into enlarging wounds. Wounds Caused by Physical Traumas: Damages in tissues or nerves due to such external factors as falling, hitting and sticking are physical traumas. Immediately after trauma, first intervention is done to the patient by the emergency service doctor and if deemed necessary, depending on the severity of and the damages caused by trauma and in consultation with other specialized doctors, a surgical intervention may also be performed. Also if and when the specialized doctor deems it fit to treat the wound by dressing and care after surgical intervention or without any surgical intervention, the wound must again be cared and dressed under supervision of a doctor