It is estimated that there are at least 8 million people in America are living with a chronic or non-healing wound or ulcer. Most people with a chronic wound have multiple comorbidities such as diabetes, obesity, heart disease, immune-compromising conditions, Peripheral Vascular Disease (PVD), and advanced aging. Certain medications, poor mobility, and poor nutrition can also be a factor in delayed healing. Chronic ulcers can result from a traumatic injury, surgery, or may develop on their own for no apparent reason. The most common types of ulcers are diabetic, arterial, venous, and pressure ulcers.

Diabetic Ulcers

Diabetic ulcers are found on the feet, heels, and toes due to poor circulation and nerve damage. Many times the visual appearance of the ulcer does not look as severe as what is actually occurring beneath the surface. Treating these ulcers includes: preventing infection, keeping tight control of blood sugars, and off-loading the ulcer. Off-loading is accomplished with special shoes, using a walker or wheelchair, or with casting of the lower leg.

Arterial Ulcers

Arterial land venous ulcers are the result of a compromised vascular system and inadequate blood flow feeding the tissues. Someone with an arterial ulcer will have pain as the leg is elevated and the skin becomes pale, but the leg is dangled it reddens and the skin may be cool to the touch. If the decreased blood flow is significant enough, surgical intervention may be required. Venous ulcers may develop due to blood flow not moving back out of the legs appropriately. Signs of a venous ulcer include swelling of the legs that may worsen throughout the day, skin discoloring in the area above the ankle, and moderate to heavy drainage from the ulcer. A key component in treating these ulcers is with the use of compression dressing to reduce swelling, but only after having a medical professional assesses and determines is safe to do so.

Pressure Ulcers

Pressure ulcers develop in areas where there has been prolonged pressure causing tissue ischemia. Typically, these are over bony prominences such as heels, hips, elbows, shoulder blades, and tailbone. The ulcer develops as oxygen and nutrients are cut off from the tissue that is trapped between the bone and a mattress or wheelchair. People at risk of developing pressure ulcers have limited mobility from age, illness, or paralysis. Shifting weight and frequent turning are essential in prevention and as part of treating a pressure ulcer.


Untreated wounds can lead to severe complications including: infection, hospitalization, amputation, and even death. The longer the delay in seeking treatment for an ulcer, the more the risk of complications increases. Seeking early treatment by a healthcare professional is key in reducing ulcer related complications. When care is provided by a trained wound care team, amputation risk is cut by nearly half. 

The Wound Care Center at OakBend has trained physicians and staff that treat chronic ulcers. Debridements are performed in the center to remove bioburden or non-viable tissue and promote healthy tissue growth. Wound dressings are selected for each individual person to provide an environment which promotes healing. Attempting to heal a chronic ulcer begins with identifying the underlying cause of the ulcer, which is why blood work, vascular tests, or cultures may be required to assist in developing each person’s plan of care. If you, or someone you know has a wound or ulcer that is not healing, please visit our website at or call 281-633-4900 to schedule an appointment.

Content for this wound care blog was provided by Kenchen Schaefer, AVP Nursing at OakBend Medical Center. 

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