Poorly Healing Wounds – Frequently Asked Questions

Poorly healing wounds are cuts, sores, or ulcers that take longer than usual to close due to underlying health conditions or poor circulation. They often develop on the legs, feet, or pressure points and can increase the risk of infection and complications if not properly treated.

Several factors can delay wound healing, including:

✔ Poor circulation – Conditions like Peripheral Vascular Disease (PVD), Venous Reflux can impede sufficient blood supply to the wound.
✔ Infections – Bacteria can slow down the healing process and cause further tissue damage.
✔ Diabetes – High blood sugar affects nerve function and blood flow, increasing the risk of chronic ulcers.
✔ Chronic venous insufficiency – Damaged veins prevent proper blood flow back to the heart, leading to pooling of blood in the legs.
✔ Malnutrition or vitamin deficiencies – Lack of Vitamin C, Zinc, and Protein slows tissue repair.
✔ Weakened immune system – Age, chronic illnesses, or certain medications can impair healing.
✔ Repeated trauma or pressure – Wounds on pressure points (heels, toes, or bony areas) are at higher risk.

If left untreated, these wounds can lead to serious complications, such as:

• Infections–  including cellulitis, abscess formation or bone infections
• Chronic ulcers-  such as diabetic foot ulcers or venous leg ulcers
• Gangrene– tissue death that may lead to amputation
• Sepsis– a life-threatening infection that spreads through the bloodstream

Signs that a wound may not be healing well include:

✔ Persistent redness, swelling, or pain around the wound.
✔ Yellowish or green discharge (a sign of infection).
✔ Increased warmth around the wound site.
✔ Foul odour coming from the wound.
✔ Darkening of the wound edges or failure to close over time.
✔ No improvement after two weeks despite home care.

• Diabetic foot ulcers – Open sores caused by diabetes-related nerve damage and poor circulation
• Arterial ulcers – Sores due to poor arterial blood flow to the legs (Peripheral Vascular Disease)
• Venous leg ulcers – Wounds resulting inadequate return of blood back to the heart from the legs (Chronic Venous Insufficiency)
• Pressure ulcers (bedsores) – Skin breakdown due to prolonged pressure, common in bedridden individuals

A vascular specialist will usually perform the following:

• Physical examination to assess wound depth, surrounding tissue, and the presence of infection
• Duplex ultrasound scan to assess blood flow in the area
• Tissue swab or cultures if an infection is suspected

Treatment depends on the underlying cause of the wound, and may include:

• • Wound Management:
    • Wound cleaning and dressing changes
    • Antibiotics- if an infection is assessed to be present
    • Pressure offloading (for diabetic foot ulcers)
    • Compression dressing (for venous ulcers)
  • Advanced Treatment Options:
    • Vacuum-Assisted Dressings (VAC): utilize negative pressure to remove excess fluid, reduce swelling, and promote the formation of healthy tissue. This creates an optimal environment for wound healing. Particularly effective for deep wounds.
    • Electrical Stimulation (ES): ES therapy applies low-level electrical currents to the wound, which can encourage tissue regeneration, increase blood flow, and reduce bacterial load.
  • Surgical Procedures:
    • Wound Debridement: Removal of dead or unhealthy tissue to promote healing
    • Angioplasty and Stenting: Blood supply to non-healing diabetic wounds is often reduced due to peripheral vascular disease. In such cases, angioplasty and stenting can help restore blood flow to the area, supporting the healing process.

• Venous Reflux Surgery: For venous ulcers. Helps with healing and mitigates risk of wound recurrence.

• • Skin grafting: For extensive wounds. Can be performed once the wound bed is ready.

• Manage and optimise underlying conditions (diabetes, vascular disease)
• Keep wounds clean and properly dressed
• Avoid smoking, as it restricts blood flow to tissues
• Maintain a healthy diet with adequate amounts of protein, vitamins C and D, and zinc
• Stay active to improve circulation and prevent blood pooling in the legs
• Regularly check your feet and legs if you have diabetes or venous disease

You should seek medical attention if:

⚠ A wound does not improve within two weeks.
⚠ You notice increased pain, swelling, redness, or discharge.
⚠ The wound develops a foul odour or blackened tissue (a sign of tissue death).
⚠ You have diabetes or poor circulation and develop a new wound.

If you’re dealing with a slow-healing wound or need expert wound care, we’re here to help.

📍 Visit: Novena Vascular & Varicose Vein Centre. 38 Irrawaddy Rd, #08-48, Singapore 329563
📞 Call or drop a message on WhatsApp: (+65) 9727-0788
📧 Email: contact@drdarryllim.com
🌐 Website: https://drdarryllim.com