Non-Healing Wounds or Ulcers

Your body needs fresh, oxygenated blood to keep your tissue fresh, and maintain a healthy bodily system. If your body is not receiving the blood it needs, perhaps due to an underlying health condition, serious health complications can ensue, such as non healing wounds or ulcers. If left untreated, non healing wounds and ulcers can pose a serious risk to your health. Severe cases may lead to amputation of the affected limbs and even death. 

Non-Healing Ulcers or Wounds

Non-healing wounds or ulcers do not heal normally. If they persist beyond three weeks, they are referred to as chronic wounds. The extreme ramifications associated with these wounds can be a heavy burden for affected patients. That being said, our board-certified vascular surgeon at Monterey Bay Vascular is dedicated to administering effective treatment and management solutions to all patients so they can live a healthy, pain-free life.

Types of Non-Healing Ulcers

These account for 70% to 90% of non-healing wounds or non-healing ulcers. Mostly occurring in elderly patients, they are believed to come about as a result of valve failure of the valves in the blood vessels. These valves are responsible for preventing the backflow of blood as it passes through them. When blood backflows, nutrient and oxygen-rich blood is hindered from reaching the tissue that is attempting to heal.

These ulcers are brought on by restricted blood flow to certain regions of the body due to the persistent and prolonged application of pressure upon them. It is seen most commonly among patients with full or partial paralysis and those who are bedridden for extended periods.

These are also highly prevalent as cases of diabetes become increasingly common. In fact, the prevalence of chronic wounds among diabetics makes this demographic 15% more likely to undergo limb amputation as a complication of their diabetic ulcer.

The high rate of limb amputation among diabetics is attributable, in part, to the neuropathic effects associated with diabetes. Neuropathy leads to a lack of pain perception, meaning that you may be entirely unaware of minor wounds on your feet and legs. If these wounds are not treated, the tissue cannot heal and they can become infected. The immunosuppressive effects associated with diabetes also make it harder for patients to fight these infections.

Causes of Non-Healing Wounds

The underlying factors contributing to the risk of developing a non-healing wounds or ulcers are widely varied. What they have in common is their ability to interfere with the way the body normally functions with regard to wounds.

A person’s circulatory system is responsible for delivering blood rich in oxygen and nutrients to all the tissues in the body that need it. Without it, tissues will begin to die. Due to their extremity (distance from the heart) and the effect of gravity, a person’s feet will often be the first problem area for a person with an impaired circulatory system. Peripheral artery disease (PAD) is a particularly culpable condition in this instance as it may lead to numbness, skin discoloration, severe pain, ulcers, or even the patient’s demise if left unchecked.

The formation of non-healing wounds or ulcers will indicate that an advanced stage of certain conditions has been reached in a patient. These conditions include high blood pressure, diabetes, kidney failure, high cholesterol, or peripheral artery disease (PAD). These conditions contribute to the formation of ulcers by causing ischemia, or the interruption of oxygenated blood to all parts of the body, or by damaging the nerves in the wound areas…

Contributing Lifestyle Habits

Some various habits and lifestyles will place patients at a heightened risk of developing non-healing ulcers. Smoking, for instance, has the effect of narrowing the vessels carrying blood to body tissues, thus increasing one’s chances of developing ulcers. A sedentary lifestyle involving little to no active movement will also carry the risk of encouraging ulcer development due to the constant pressure applied to certain tissues. Old age is also a factor here, as our skins will gradually lose their ability to repair themselves as quickly and efficiently as they once did.


This condition is prevalent in people living with certain circulatory ailments such as atherosclerosis, diabetes, alcoholism, etc. In a healthy person, the nerves will send signals to the brain whenever pain or discomfort is experienced in any body tissues. Neuropathy makes this system non-functional; tissue can be damaged without warning signals being sent to the brain. This will prompt the person to change position or remove the object, causing injury. Over time, the affected area might see the development of an ulcer.

Symptoms of Non-Healing Wounds or Ulcers

If you are at risk for a non-healing wound or ulcer, seeking treatment as early as possible is crucial. If the surrounding tissue is not properly treated, you are at high risk for developing a serious infection. Look out for the following warning signs for a non-healing wound or ulcer.

  • Dark or blue-hued discoloration around the wound’s edges
  • Significant pain around the wound that persists without improvement or progressively gets worse
  • Foul odor or smell emanating from the wound
  • Swelling and redness emanating from the wound and spreading to surrounding skin and tissue
  • Continuous leaking or draining from the wound.

These symptoms are all conducive with a serious infection. An infection indicates that your body cannot naturally heal the wound by itself. If you notice any of these signs, seek medical intervention immediately to avoid any life-threatening complications.

Treatment of Non-Healing Wounds

There are many different  causes that may contribute to the development of non-healing ulcers. With that comes an array of treatment methods. A doctor will discuss the available options with their patients in order to formulate an effective treatment plan. However, the type and severity of the wound will impact of the degree of treatment required to heal the wound. 

Compression wrapping helps provide support to the vascular system through a tightly bound wrap around your affected limb. Your veins and arteries have likely been worn down and, as a result, been unable to provide your tissues with proper blood flow. Compression wraps stimulates blood flow and helps your tissues get the nutrients they need to heal your wounds.

Specialized dressings contain medications and other components that aid in wound healing. Topical antibiotics may also be prescribed for non-healing ulcers to reduce the bacterial levels present in the wounds and prevent further infection.

There are plenty of measures that patients will be able to implement to treat and manage their non-healing wounds or ulcers if they are properly educated. Regular cleaning, sterilization, proper bandage care, manual repositioning of paralyzed limbs, and avoiding habits that contribute to ulcers will be significantly helpful to you.

This treatment method works by pulling away the fluid in the wound that nourishes bacteria by applying negative pressure. Also known as vacuum-assisted wound closure, it will also reduce tissue swelling and bring up fresh blood and nutrients to the targeted area.

Surgical procedures may be necessary to treat severe non-healing wounds or ulcers. Patients with atherosclerosis or blood clots in their vascular system, for example, might undergo surgical procedures to remove these clots or clear excess plaque in their system. Treating these conditions helps to combat the formation and persistence of non-healing ulcers.

Growth factors refer to naturally generated biomaterials in our bodies that replace tissues when they are damaged or degraded. This process is crucial when a wound is healing. These factors include epidermal growth factor, insulin-like growth factor (IGF), vascular endothelial growth factor (VEGF), and more. During growth factor therapy, your physician will introduce or stimulate these factors directly onto the wound in order to speed up the healing and re-growing processes.

Skin grafts taken from donors are another option to explore. Also referred to as allografts, these grafts provide a covering to the wound without integrating with the host body. They work by fostering a growth structure of epithelial cells. However, severe cases might not be suitable for debridement and will do better with grafts taken from elsewhere on the patient’s own body.

Debridement more simply refers to the removal of dead or dying (necrotic) tissue from the site of a non-healing wound. The goal is to minimize the risk or opportunity for infection by eliminating the necessary medium for bacterial growth and proliferation, which such tissue provides. This is an especially relevant measure undertaken in the fight against diabetic non-healing ulcers, as amputation will usually be carried out in cases where infection has progressed past a certain limit.


This is the idea behind the rather outlandish yet scientifically sound application of maggot therapy in the management and treatment of chronic wounds. Here, live, disinfected maggots will be introduced to the wound by a medical professional. Maggots will happily devour necrotic tissue while not touching healthy tissue. This directly leads to a reduction in the bacterial presence in the wound, thus encouraging rapid healing as well as pain and odor mitigation.

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Treating vascular conditions and ailments requires extensive expertise. At Monterey Bay Vascular, we have honed our specialized skill set to be at the forefront of new techniques and technology. We hope to facilitate the very best outcomes for our patients every day. Contact us today and schedule a screening for comprehensive care you can trust.