Wound care and what you need to know

Key points:

Over 420,000 Australians suffer from chronic wounds each year
Diabetes (including diabetic foot disease), cancer and venous leg ulcers are among the leading causes of chronic wounds
If untreated, serious wounds may lead to infection, amputation or even death

Skin wounds can be caused by a number of incidents, such as a knock against a hard surface.

As you age, you will notice that cuts and bruises take longer to heal, and even a minor scrape could turn into a nasty wound if left untreated.

Knowledge of appropriate wound care is incredibly important, whether for yourself or a loved one. The correct treatment of a chronic wound can make all the difference in maintaining comfort at home or avoiding life-threatening outcomes.

If a skin wound fails to heal, heals slowly or even recurs, it is classed as a chronic wound. Over 420,000 people suffer from chronic wounds each year in Australia, many of which are aged over 65 and some have health complications associated with ageing or disease.

This article is intended for informational purposes only and is not a substitute for medical advice, diagnosis or treatment. The best course of action is to seek professional medical advice when you suffer a serious cut or injury, or if a wound deteriorates.

The causes of chronic wounds

The natural ageing process impacts the body’s ability to heal itself quickly. That’s why your bruise from bumping into a door handle or a cut from a branch scratching you in the garden could last weeks, instead of just days.

This is because the healing process is slowed in older people. The normal healing process includes three stages – the inflammatory, fibroblastic and maturation stages – but in old age, these are slowed and delayed.

Even the final maturation stage, where the healed skin strengthens and scars fade, can take years for a young person to complete, let alone the time it could take for older people, which is why understanding proper wound care is important.

Most chronic wounds are caused by trauma to the skin, burns, bedsores, skin cancer or infection. There are also a number of diseases that increase the likelihood of chronic wounds and delay the healing process further, including diabetes, cancers, heart disease or venous leg ulcers.

Diabetic foot disease is one of the most impactful diseases of all, affecting roughly 50,000 annually, while 300,000 other Australians with diabetes have risk factors for developing the condition.

Chronic wounds do have wide-ranging impacts. Not only are they painful, but they can cause decreased mobility due to the pain, which in itself could lead to bedsores or other health complications.

Wound care is also costly, as a person with a chronic wound could spend more than $4,000 on out-of-pocket medical expenses each year. The anticipated financial burden means many people avoid visiting a General Practitioner (GP) or doctor, and the wound worsens.

If infection or complications occur, hospitalisation, amputation or death could result – all of which would have been avoidable through proper wound care and management.

As a result, early intervention by a healthcare professional can avoid chronic wound deterioration. But it also helps to understand the principles behind proper wound care for ongoing management and treatment at home.

Assessment and diagnosis

Before a chronic wound is treated, it is necessary to understand the cause and best treatment methods. You should visit a healthcare professional if you have a serious or chronic wound to ensure you are provided with the most accurate information for ongoing care.

A doctor can assess the wound to determine if there is an underlying condition at fault, like diabetes, if antibiotics are required for an infected wound, or if surgery is necessary for an ulcer.

There are also a number of other interfering factors that could slow down the healing process. Some medications can impact the body’s healing process, while necrosis can also occur.

Necrosis is the death of body tissue and it will initially cause skin redness, wound swelling, blisters and warmth. It cannot be reversed and medical intervention will be necessary to limit the damage from infection or gangrene (when necrosis spreads to a large area of tissue).

If you are faced with a minor wound but do not know how to treat it, your local pharmacist can offer advice on the best treatment options. Some pharmacies also offer wound care services, and you can locate them through Find a Pharmacy.

An upfront diagnosis is the best way to ensure the right treatment occurs. With the right information on hand, you can appropriately manage and care for any wound.

Cleaning, dressing and management

For a wound that does not require immediate medical attention, you can provide the correct care at home. However, if there is a large amount of bleeding or it is deep, press down on the wound with a sterile gauze or clean cloth and contact triple zero (000).

If the wound is not serious, or you are providing ongoing wound care, you want to make sure you always start by thoroughly cleaning and sanitising your hands with soap or hand sanitiser. You should also wear a pair of disposal gloves – avoid latex in case of allergies.

Working in a clean environment free of dust, fur or distractions, clean and sterilise the wound. You can use gauze, cloth or bandage soaked in a saline solution or warm, clean tap water to gently dab and wipe the skin and remove any dirt or debris.

Alcohol-free wipes or an antiseptic liquid can be used, although doctors recommend avoiding antiseptic creams, washes or sprays on chronic wounds as it harms cells that are involved in wound repair.

Next, pat the wound dry using a cloth or clean towel that will not leave any fibres behind. Once dry, apply a sterile dressing.

For the management of chronic wounds, your doctor will recommend a specific type of dressing based on the severity. Moist dressings are often recommended for chronic wounds as they retain moisture and are not painful to remove.

If you are unsure about a specific dressing for a minor wound, contact or visit your local pharmacist.

When you are tasked with ongoing wound care, you want to make sure that dressings are changed and the wound site is cleaned regularly. But there are different recommendations for this timeline.

For example, dressings should be changed and reviewed every five days for a chronic wound, while an infected site should be changed every one or two days.

Confirm with a doctor or healthcare professional what the best review times are for the wound to make sure the bandage is changed appropriately, the site remains clean and the healing process can be monitored.

If a wound turns red or swollen, you see pus or discharge when changing the bandage, or you develop a fever, seek medical attention immediately. You will need the correct treatment and antibiotics for an infected wound.

If you are uncomfortable with treating a wound at home, or unable to, there are professional nursing services that provide wound care in the home. Bolton Clarke, formerly RSL Care and Royal District Nursing Service (RDNS) and National Home Nurse services provide wound care services at home, while you can access them through existing Commonwealth Home Support Programme (CHSP) and Home Care Package (HCP) services.

Tips for wound care

Alongside a good routine with your bandage, there are several other steps you can take to support healthy wound care.

Healing is supported by your body and you can include vitamin-rich foods to provide it with the correct nutrients. Vitamin C, vitamin A and zinc are the best, and they can be found in many fruits and vegetables. You can also ask your doctor about taking vitamin supplements to help.

Anti-inflammatory drugs such as aspirin should be avoided as they slow down the immune system’s response to cuts or wounds. Make sure you speak to your doctor about which medicines to avoid if you are taking anything regularly.

You want to keep your wound dressed rather than letting it heal and dry out in the air. Wounds require warmth to heal and if it’s exposed to the open air for too long, they will cool down and the healing process will slow down for a few hours.

It’s also important to keep as active as possible with a wound, particularly if it’s a pressure sore. Exercise increases blood flow, which prompts faster healing. Talk to your doctor about safe exercises and movements that will help the healing process.

Have you looked after a chronic wound at home? Tell us more in the comments below.