This is usually a break in the skin with an ulcer over any part of the body. Some of these wounds may have been present for over 1 month and have been unable to heal on their own. These wounds may also have secondary bacterial infections resulting in pus discharge, bad odours and surrounding redness and pain.
Chronic wounds are usually found at sites where:
Patients who have diabetes or are immunocompromised are also at risk of developing chronic non-healing wounds.
For a chronic wound to heal, we must treat 2 key components – the underlying cause and the actual wound itself. For example, if there is underlying peripheral artery disease causing poor blood supply to the region of the wound, then the patients should undergo surgery to treat the artery disease (e/g angioplasty/ stenting) to improve the blood flow to the wound. If there is underlying infection, then the wound may need to be cleaned surgically and antibiotics started.
We then use different techniques with various types of dressing preparations to treat the wound itself. The dressings range from simple gels applied to the wound to complex types like Vacuum Assisted Closure (VAC) or maggot therapy. Our aim is to have complete healing of these wounds with return of functionality.
Lymphoedema is swelling which affects the limbs due to failure of the lymphatic channels. Lymphatic channels serve to help drain fluid from the extremities as well as act as an immune gatekeeper (lymph nodes).
The main aim of treatment is to reduce the limb swelling and allow return of function. Lymphatic drainage massage as well as compression dressings help reduce swelling significantly, but both have to be done on a regular basis (usually 3 times a week) . Newer therapies include surgery to connect the blocked lymph drainage channels to small veins (lymphovenous bypass) or lymph node transplants to the affected limb.