Chronic Wounds 

Causes:

• Venous insufficiency

• Arterial disease (PAD)

• Diabetes mellitus

• Pressure injuries in immobile patients

Symptoms:

• Non-healing wound >4 weeks

• Swelling, discoloration, or pain

• Possible foul-smelling discharge or infection

• Tissue necrosis or exposed bone (in severe cases)

Diagnosis:

• Clinical examination of wound characteristics

• Ankle-Brachial Index (ABI) to evaluate arterial flow

• Duplex ultrasound for venous insufficiency

• Wound culture if infection suspected

Treatment:

• Debridement (surgical or enzymatic)

• Moist wound healing with appropriate dressings

• Revascularization if ischemia present

• Offloading (e.g., custom orthotics for diabetic foot ulcers)

• Antibiotics for infected wounds

• Hyperbaric oxygen therapy in selected cases

 Complications:

• Osteomyelitis (bone infection)

• Amputation

• Sepsis

 Follow-up:

• Multidisciplinary wound care (vascular, endocrinology, podiatry)

• Blood glucose control in diabetic patients

• Smoking cessation and lifestyle modification