These wound must be treated with medication. You may be suspicious that you have this type of wound if it has a bad odor, pus drainage, debris or dead tissue that is a yellowish to green color. You may experience symptoms of inflammation such as fever, pain, redness, heat, and swelling.13
- Staphylococcus aureus
- Necrotizing Fasciitis Also known as necrosis or a flesh eating bacterial infection, results in the destruction of the cellular make up of the skin and subcutaneous tissue. The most common strain of bacteria that cause this infection are group A streptococci or staphylococci but can be causes by many other bacterial organisms as well. The primary method of transfer for this bacteria is through the skin or open wounds. Those at risk are anyone with a compromised immune system due to diabetes, cancer, kidney disease, or those who are taking steroids.
- Pilonidal Cysts
The wound is not getting enough blood supply so it is not getting enough oxygen or nutrients it needs for healing; this delays or prevents healing. Usually the area of the wound is pale and cold. There may also be a decrease in hair growth and a weak pulse sensation in the area.13
- Gangrene- this condition occurs when there is an inadequate blood supply to an area causing poor nutrients and oxygen supply; it will eventually cause a breakdown of the tissue (ischemia). This usually occurs in places in the blood with very small blood vessels like the toes or fingers because it is easier for these smaller blood vessels to become blocked. Some causes of Gangrene include bacterial infections, atherosclerosis, arteriosclerosis, trauma, or injury to a blood vessel. Common sign and symptoms are pain, swelling, bluish or blackish skin discoloration, foul-smelling discharge, and fever.
This could be caused from therapeutic gamma rays or x-rays, or accidental from exposure to radioactive material. This weakens the immune system and damages exposed tissue. These wounds can present with redness, blistering, itching, inflammation, and other unspecified symptoms that include but are not limited to nausea, vomiting, abdominal pain, and fever.13
- Soft tissue radionecrosis- As a result of exposure to ionizing radiation the soft tissues start to die. Radiation leads to the proliferation of small arteries and capillaries causing decreased blood flow. This causes a decrease in oxygen and nutrients to the area leading to ischemia and the tissue start to die. The cells are damaged but can still survive until a trauma occurs to the area and this will cause the tissues to die. After this, the result is ulceration.
- Osteoradionecrosis- This is the death of bone tissue due to the exposure of radiation.
These wounds are caused by incisions made during surgery that progress to chronic wounds when the area does not heal properly. Typically you will see a red, hot, and swollen surgical incision site.
- Wound dehiscence- These wounds are caused by the skin at the surgical site breaking open along the suture. This can be caused by poor surgical technique due to improper suturing or inappropriate type of suture. It can also be caused by increased stress to the wound area due to a strenuous activity. Wound dehiscence could also be secondary to poor healing, wound infection, malnutrition, weakened immune system, or those with AIDS, diabetes mellitus, renal disease, and those undergoing radiation or chemotherapy. Some signs or symptoms are an open wound, broken sutures, pain at the wound site, bleeding, and/or pus.
- Pylonidal cysts- these cysts occur at the bottom of the tailbone which can become infected and begin to pus. It will appear to look like a large pimple. These cysts are more common in men and occur mostly in the 4th decade of life. Some symptoms of pilonidal cysts include pain, redness, and swelling at the bottom of the spine, pus drainage, and a fever.14
These are the most common type of chronic wounds13
- Arterial- These wounds may be due to hypertension, atherosclerosis, and thrombosis. These wounds often lead to ischemia. These wounds usually involve the full thickness of the skin, and appear to have a punched out appearance with smooth edges. Pain usually subsides when the legs are below the level of the heart.
- Venous- These wounds make up more than half of cases. They are due to deep vein thrombosis, varicose veins, and hypertension. The skin of these wounds appears shiny and smooth, and often times have little to no hair. These ulcers are superficial on the skin, irregularly shaped, and cause a lot of pain and swelling.
- Decubitis (Pressure)- Also referred to as bed sores, these wounds are caused by constant pressure on a localized area that can lead to breakdown of the tissues in that area. The prolonged pressure cuts off circulation to that particular are of your body causing insufficient nutrients and oxygen to your cells. Eventually, this will cause those cells to break down. These wounds present with a lot of redness that when pressed upon doesn Bedsores can appear at any part of the body but are most common in the low back, hip, tailbone, ankles, and elbow. Those most at risk include but are not limited to the elderly, those with diabetes, or those bound to either a bed or wheelchair.
- Diabetic- These wounds are common with people who have uncontrolled diabetes mellitus. The biggest concern with those who suffer from diabetes mellitus is the delayed or poor healing rates. These wounds can lead to an impaired immune system, ischemia, neuropathy, and ulceration of skin unless these patients are properly taken care of. Neuropathic diabetic ulcers are secondary to nerve damage which will cause a lack of sweat making the skin dry. The dry skin cracks easily and will become scaly or form calluses. These dry skin patches and calluses eventually will break down and form an ulcer. If an ischemic origin is present, the ulcer area is cool with no pulse. Patients with diabetes develop narrowing of the blood vessels in their body which will cause a decrease in blood circulation. The decrease in blood circulation is what causes the delayed healing.13
- Rheumatoid Arthritis- Arthritis is an inflammatory condition in the joints that is characterized by redness, swelling, warmth, and pain. Rheumatoid arthritis (RA) is a chronic form of arthritis which occurs on both sides of the body. Symptoms of RA include but are not limited to joint pain and swelling, stiffness especially in the morning or after long period of sitting, and fatigue.18
- pyodermic gangrenosum- is a rare condition that causes very large painful sores to develop on the skin. This occurs most commonly in the legs and although it is not known what causes these wounds, it is believed to be a disorder of the immune system. Those with other conditions like rheumatoid arthritis or inflammatory bowel disorder are at higher risk for developing pyodermic gangrenosum. It can take months to heal these type of wounds.19
- antiphospholipid syndrome- is a disorder in which your body produces antibodies against certain normal proteins in your blood. This condition can cause blood clots in your which is known as deep vein thrombosis. There is no cure for this syndrome however; medication can help reduce the risk of clot formation.
- *Connective tissue-
- scleroderma lupis- scleroderma is an autoimmune chronic condition which is characteristic of hard skin due to increased deposits of collagen. The two types of scleroderma are localized and systemic. Localized scleroderma affects the skin in limited areas and the musculoskeletal system. Systemic sclerosis more widespread damage to the internal organs such as the lungs, heart, and kidneys. This condition could also cause arthritis, slow contractions in the GI tract, muscle inflammation, or dry eyes and mouth. People with the condition may develop Raynauds disease which causes cold-induced spasms in the blood vessels of their hands and feet. These cold-induced spasms turn the fingers or toes white or blue and may be painful. For more information regarding this condition please visit www.thelupussite.com.
- Metabolic- (diabetic)
- vasculitis- is characterized by inflammation of the blood vessels. The cause of vasculitis is unknown however it is believed certain drugs can cause this to occur. Drugs which suppress the immune system such as corticosteroids are often administered to help decrease the inflammation and relieve the symptoms of fever and/or fatigue. This condition occurs because the immune system mistakenly identifies blood vessels as foreign and attacks them. Learn more about vasculitis.