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Healthy Living Blog

Chronic Wounds

April 08, 2019 | Dr. Marc Dolce


Chronic wounds affect 6.7 million people in the United States with that number rising at an expected rate of 2-percent annually over the next decade. Chronic wounds are most common in individuals over 60 so as the population ages and rates of diseases such as diabetes and obesity rise, so do the incidences of chronic wounds.

It’s important to understand chronic wounds so that you can get help healing it before it becomes a bigger problem.

What is a chronic wound?

Chronic wounds are wounds that do not progress through the phases of healing in order and in a predictable amount of time. Typically, a chronic wound is one that has not shown progress in healing in 30 days.

Most minor cuts, wounds, and scratches heal on their own within two weeks. Chronic wounds stay open longer due to diabetes, poor nutrition, circulatory problems, chronic infections, limited mobility or trauma.

Some common types of chronic wounds requiring treatment include:

  • Diabetic ulcers. Diabetes causes neuropathy, or the loss of feeling in extremities. Due to this loss of feeling, diabetes patients may not notice small wounds on their legs and feet and because of that, they may fail to prevent infection or repeated injury. Diabetes also prevents oxygen from adequately reaching tissue which can make wounds more difficult to heal.
  • Pressure ulcers. Also known as bedsores, a pressure ulcer is caused by prolonged sitting or lying in one position. These are often found on the tailbone, heels, elbows, shoulder blades, knees, ankles, and the back of the head or spine.
  • Arterial ulcers. A round-shaped wound caused by impaired circulation often seen on legs or feet.
  • Venous ulcers. These usually occur in the legs and account for more than 70 percent of chronic wounds. They develop when the valves that prevent blood from flowing backward malfunction, allowing blood to pool, cause swelling, and cause an ulcer.
  • Cellulitis. A common bacterial skin infection.
  • Trauma
  • Non-healing surgical wounds
  • Any wound that has not healed in one month

Treatment of chronic wounds

The Fisher-Titus Center for Wound Healing uses several methods to treat chronic wounds. When treating patients, their goals are to heal the wound and keep it healed, increase comfort and mobility, prevent infection, prevent amputation, and help restore quality of life.

Some of the methods they use include:

  • Advanced wound dressings
  • Negative pressure wound therapy
  • Bioengineered tissue
  • Debridement (removal of damaged tissue or foreign objects from a wound)
  • Wraps to decrease lower leg swelling
  • Hyperbaric Oxygen Therapy (HBOT)
What is HBOT?

HBOT sessions, which last about two hours, are painless and occur in a transparent chamber containing 100-percent oxygen. Fisher-Titus has two monochamber HBOT units.

Most chronic wound patients receive between 30 and 40 treatments. HBOT treats a variety of conditions including diabetes-related wounds of the lower extremity, chronic bone infections, radiation injury and compromised skin grafts.

HBOT allows your lungs to gather up to three times more oxygen than would be possible breathing at normal air pressure. Your blood then carries this oxygen throughout your body, where it can help fight bacteria and stimulate the release of growth factors and stem cells. HBOT triggers your body’s natural wound healing abilities to function more efficiently and better fight infection.

Dr. Marc Dolce is board-certified in podiatric surgery and is co-medical director of the Fisher-Titus Center of Wound Healing. He also serves as chief of staff of Fisher-Titus Medical Center. Dr. Dolce is a member of the Fisher-Titus medical staff and practices podiatric surgery at Northern Ohio Foot & Ankle Specialists in Norwalk, New London, Sandusky and Bellevue. To schedule an appointment at the Center for Wound Healing, call 419-660-6980.