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Chronic Wounds

Chronic Wounds - When Healing Becomes a Challenge

Chronic wounds can be a difficult challenge for those affected and can have a significant impact on everyday life. In this article, we would like to convey the topic of chronic wounds and show those affected a variety of ways to deal with their symptoms.

Chronic wounds are unfortunately an unavoidable reality when they fail to heal over a period of 4 to 12 weeks, despite extensive treatment. It is unfortunate that these types of injuries can be persistent and occur on various parts of the body. The causes of this condition are many and require special attention.


There are some signs to look out for in a wound:

  • Yellowish, greasy or even black coatings indicate that the wound is not healing optimally.
  • An unpleasant odor is also an indicator of a poorly healing wound.
  • A swollen and painful area around the wound may also indicate that complications have developed.
  • If the wound is also oozing, this is not a good development.
  • Finally, it can also happen that pathogens additionally penetrate the already stricken area.


A poorly healing wound is an unpleasant affair that is favored by various diseases and circumstances. Impaired blood flow due to venous or arterial disease as well as cardiovascular disease can lead to this condition. Metabolic disorders such as diabetes mellitus and rheumatic diseases can also contribute to slower wound regeneration. Poor nutritional status can make matters worse. So, it is very worthwhile to take good care of your physical health and adequate nutritional intake to minimize this risk!

Chronic Wound Examples:

These are the most common types of wounds: chronic wounds examples.

Venous lower leg ulcer, open leg


When a venous open leg develops, the first signs appear that should not be ignored under any circumstances:

  • Swelling in the evening increases and brings discomfort.
  • After longer periods of sitting or standing, edema in the legs becomes more frequent.
  • A pulling or dull pain may occur and hardening and thickening in the lower leg area can be felt.
  • Brownish-yellowish discoloration of the skin can be an indication of an incipient disease.
  • Itchy, inflamed areas, so-called "stasis excema", occur more frequently.
  • In addition, it is possible that there is no sensation of pain - but this does not automatically mean improvement!
For this reason, specialist advice should definitely be sought for these symptoms.


How is the venous open leg/lower leg ulcer treated?

To solve the problem, it is necessary to have the open wound on the leg treated. The wound therapy as well as the elimination of the venous blood stasis are of crucial importance:

  • First, the wound must be professionally cleaned to remove coatings and germs to aid in the healing process. Expert medical care by nurses or wound specialists is essential in this process.
  • Second, in some cases it may be useful to use surgical measures to treat the cause - for example, by vein removal or sclerotherapy.
  • Thirdly, a compression bandage should be applied, which helps to restore the return flow of blood. This effect is further enhanced by elevating the legs.
  • Finally, regular walking or gymnastic exercises additionally promote blood circulation in the affected area.
  • Adequate compression therapy plays a central role here!
It is essential that compression therapy be used as the primary therapeutic measure in the treatment of venous wounds.

 Compression therapy is an extremely effective method of relieving the veins and preventing blood stasis. Bandages of different strengths are applied, and their targeted pressure ensures that dilated veins are reduced. This leads to improved blood circulation and faster removal of metabolic products and fluids.

In addition, such therapy promotes the reduction of swelling and supports faster wound healing. For these purposes, in addition to conventional compression bandages, there are also special compression stockings that can enhance this positive effect.

Important: Walking and lying is better than sitting and standing!

Arterial leg ulcer, open leg


Arterial leg ulcer is a highly unpleasant phenomenon caused by a lack of oxygenated blood in the tissues. It is caused by the calcification of our arteries - an extremely unfortunate circumstance. These constrictions lead to painful circulatory problems and can literally force those affected to take short breaks again and again. Unfortunately, these are symptoms of a widespread disease called pAVK or also known as shop window disease.

Particularly tragic are those wounds that occur on the parts of the body that are farthest from the heart - for example, on our feet or toes.

Factors favoring

Causes that favor the occurrence of leg ulcers due to arterial problems:

  • tobacco use
  • overweight
  • high blood pressure   
  • diabetes mellitus
  • elevated cholesterol levels
  • familial heredity
  • lack of physical activity


It is of great importance that arterial occlusive disease is treated depending on the stage of the disease. Various promising treatment options are available, such as the use of drugs that promote blood flow (anticoagulants/anticoagulants), dilating narrowed vessels with a balloon (PTA = percutaneous transluminal angioplasty), inserting a tube (stent) that keeps the vessel open, or even bridging the narrowed area with a vascular bridge (bypass).

But please remember: If there are any changes or injuries to your legs or open foot, you should see a doctor immediately!

Bedsores (decubitus ulcers)

Around the topic of bedsores, also known as decubitus, we have created a separate article.  You can find the information about decubitus here.

Diabetic foot (diabetic foot syndrome)

Diabetic foot syndrome is an extremely unpleasant consequence of diabetes that can lead to poorly healing wounds on the feet. These wounds occur due to circulatory problems or nerve damage (neuropathy), which can be caused by diabetes. It is therefore necessary for people with diabetic foot syndrome to take extra good care of their feet and keep an eye on them to avoid complications.

Symptoms for circulatory disorder

Worrying signs of a possible circulatory disorder include painful sores on the feet, cold feet and bluish discoloration of the skin around the foot region. It is of utmost importance to take these symptoms seriously and seek immediate medical attention to avoid possible complications.

Symptoms for nerve damage

Possible symptoms of nerve damage can be extremely unpleasant. There may be sensations of discomfort, such as a feeling of heaviness or sludginess when walking. Numbness in the feet is also not uncommon and is often difficult to ignore. Furthermore, burning or electrifying pain may occur, known as neuropathic pain, which can be caused by nerve damage. Very dry skin on the feet may also indicate such an injury and should not be underestimated.

Even the smallest injuries, which can be caused by inappropriate foot care or uncomfortable footwear, are no longer noticed. This leads to a worrying phenomenon: pressure ulcers develop - similar to bedsores (decubitus ulcers).

These can spread so much within a very short time that they even affect the bone and cause rapid inflammation.


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Treat chronic wound: A healthy diet effectively supports the healing process

You can treat a chronic wound by paying attention to a healthy diet to strengthen wound healing and the immune system. It is important to note that different vitamins and proteins are needed depending on the type and size of the wound. Tailoring dietary changes will depend on the underlying condition. For example, if diabetes is involved, professional advice may be recommended through a diabetes education program or by a qualified nutritionist.

General guidelines for a healthy diet in chronic wounds

The treatment of chronic wounds requires a disciplined and holistic approach. A healthy diet is essential here to support the body in healing. Particular attention should be paid to achieving a normal weight, as both being overweight and underweight can be harmful to the body.

A high-fiber, low-fat Mediterranean-style diet helps to provide the body with optimal nutrients. At least five portions of fruit and vegetables should be on the menu every day to absorb the necessary vitamins and minerals.

In addition to a balanced diet, it is important to drink enough fluids - at least 1.5 liters a day. However, it should be noted that prescribed drinking quantities should not be exceeded due to other illnesses. It is better to avoid sweet drinks such as lemonade or fruit juice drinks.

Despite everything, a glass of alcohol may be enjoyed in moderation - but please do so with caution!

With these general guidelines for a healthy diet, the treatment of chronic wounds is supported in the best possible way.

What to do about wound odor?

Solution and prevention

It is unquestionably an unpleasant feeling when, for example, an open wound on the leg emits a strong odor. This is largely caused by bacteria living in the wound and any dead tissue that may be present.

But don't worry: the cause of the unpleasant odor can be remedied! First, the infected tissue must be removed so that the wound remains clean and can heal.

To prevent re-infection, there are several measures to keep the body hygienic. Regular personal hygiene should be a matter of course; however, unnecessary frequent washing must be avoided as well as making sure that the skin is appropriately creamed after each care. In the case of open wounds, showers or full baths should only be taken after consultation with medical professionals - after all, safety first!

How to handle wound pain?

A chronic open wound usually causes intense pain that severely impairs normal movement. Despite medical treatment, however, there are ways to influence one's own perception of pain. By using relaxation, breathing and distraction techniques, one can counteract the suffering and bring about relief.

What should be considered when changing a dressing?

It is of utmost importance to follow all necessary instructions and precautions when changing a dressing. As a rule, chronic wound care should be carried out exclusively by healthcare professionals who have been specially trained for this purpose.

However, if you are authorized to change the dressing yourself, be sure to use only dressing materials prescribed by a physician and always follow the individual instructions for treating such a wound.

Any unauthorized action or even the use of home remedies can cause a worsening of the condition - here should not be acted carelessly under any circumstances!

What to avoid at all cost

It is necessary to keep a wound dry at all times. Under no circumstances should you use your own improvised rags or old cloths to cover the wound. Applying homemade creams and ointments can also negatively affect healing. Please do not under any circumstances use colored substances such as iodine in the wound, and avoid sprinkling or applying both sugar and honey on it.

Liquor and other alcoholic beverages should not be used to clean the wound! In addition, we strongly recommend that you do not use worn-out compression bandages as well as "long-stretch bandages" for a compression bandage.

In addition, please ensure that you do not apply any compression bandages or stockings while the wound is still open.

Avoid these measures at all costs to ensure that your injury heals quickly and successfully!

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