Ulcer Wound Care: Best Practices for Optimal Healing

At Healogics, we know that managing a wound properly is essential for healing and preventing complications. More than 6 million Americans live with chronic wounds, significantly impacting daily activities, mobility, and overall well-being. Whether you’re caring for a diabetic foot ulcer, pressure injury, or another type of wound, following the right care procedures is vital for successful healing.

While caring for a wound at home may seem overwhelming, following proper protocols makes a significant difference in healing outcomes. Our guidelines will help you:

• Monitor your wound’s healing progress
• Perform dressing changes safely
• Recognize warning signs that need medical attention
• Maintain proper hygiene to prevent complications
• Create an optimal environment for healing

Understanding Different Types of Ulcer Wounds

Each type of ulcer has unique characteristics and requires specific care approaches. Here are the most common types we treat:

Diabetic Ulcers: Often occur on feet and toes due to nerve damage and poor circulation. Early signs include redness, calluses, or blisters in pressure areas.

Pressure Ulcers: Develop where bone presses against the skin, typically on the tailbone, heels, or hips. Warning signs include persistent redness and skin discoloration.

Venous Ulcers: Form on lower legs due to poor blood flow in veins. Often accompanied by swelling, discolored skin, and aching legs.

Arterial Ulcers: Often appear on feet or toes due to reduced blood flow. Characterized by pale, cool skin and pain that worsens with elevation.

All ulcer types share some common risk factors:

• Poor circulation
• Limited mobility
• Chronic conditions like diabetes
• Previous ulcer history
• Age and nutritional status

Understanding your specific ulcer type helps ensure proper treatment. Our wound care specialists can create a personalized care plan based on your wound type and specific healing needs.

Common Causes and Risk Factors

The development of ulcers often stems from a combination of underlying health conditions and lifestyle factors. Poor circulation, whether from diabetes, vascular disease, or other conditions, reduces the oxygen and nutrients reaching your tissues. This makes healing more difficult and increases vulnerability to wounds. Reduced mobility, often due to illness or hospitalization, creates pressure points that can lead to tissue damage.

Nerve damage, particularly common in diabetes, poses a special risk because it diminishes or eliminates pain signals that would normally alert you to injury. Additionally, a weakened immune system, poor nutrition, smoking, and living at an unhealthy weight can all compromise your body’s natural healing abilities.

Age also plays a significant role, as older adults typically have thinner skin and may have multiple health conditions that affect healing. Previous ulcers increase your risk as well, making prevention especially important if you have a history of wound problems.

Understanding these risk factors helps us develop more effective prevention strategies and treatment plans. By identifying and addressing your specific risk factors, we can work together to prevent ulcers from developing or recurring.

Stages of Ulcer Development

Ulcer formation typically begins with subtle skin changes that may go unnoticed without careful inspection. The earliest stage shows redness or skin discoloration that doesn’t fade, often accompanied by warmth in the area. This is your body’s warning signal that damage is beginning.

As the condition progresses, the outer layer of the skin may break down, creating shallow open areas or blisters. Without intervention at this stage, the damage continues deeper into the tissue. The third stage involves the loss of all skin layers, exposing underlying tissue and creating a crater-like wound. In the most severe stage, the ulcer can extend into muscle, bone, or supporting structures.

Early recognition and treatment at the first signs of skin changes can prevent this progression. Even small changes in skin color, temperature, or sensation warrant attention, as addressing ulcers in their earliest stages leads to better outcomes and faster healing.

Essential Components of Ulcer Wound Care

Proper wound care combines thorough cleaning, appropriate dressing selection, and careful monitoring. Each wound requires a clean environment and specific moisture balance to heal effectively. We recommend using sterile wound cleansers rather than harsh soaps, followed by gentle patting – never rubbing – of the surrounding skin.

Choosing the right dressing is critical for healing. Modern wound care products include specialized foam dressings, hydrocolloids, and antimicrobial dressings that help maintain optimal moisture while protecting the wound. Some wounds may require advanced treatments like negative pressure therapy or specialized biological dressings to promote healing.

Professional debridement – the removal of dead tissue – may be necessary to support healing and prevent infection. This should only be performed by healthcare professionals. Regular assessment helps us determine when to adjust treatment approaches, ensuring your wound receives the most effective care throughout the healing process.

What Will Your Nurse Show You?

• How to take care of your dressing
• When and how to change your dressing
• What to watch for as your wound heals

When Should You Call the Wound Care Center® Staff Immediately?

If you notice:

• Increased pain at the wound site
• Excess drainage wets the dressing before it is time to change the dressing
• Redness or swelling around or spreading away from the wound
• Foul odor coming from the wound
• Change in color or amount of drainage from the wound
• Fever and chills
• Nausea or vomiting

Changing Your Dressing

• Gather the supplies you will need for your dressing change:
  • Trash bag
  • Wound cleanser
  • Hand washing supplies
  • Tape or gauze wrap to hold your dressing in place
• Wash your hands with soap and water. Put on gloves if available.
• Prepare a clean working area.
• Carefully remove your dressing. Throw away the old dressing in a trash bag. Try to keep the wound clean.
• Look at your wound closely. Look for any foul odors; change in color or amount of drainage; redness or swelling around the wound; or redness spreading away from the wound.
• Wash your hands with soap and water.
• Clean your wound using the cleanser prescribed by your healthcare provider.
• Put on a new dressing.
• Put the plastic bag with the old dressing in another plastic bag and put directly in the trash. This is called ‘double bagging’.
• Wash your hands one last time with soap and water.

General Information

• Change your dressing as directed by the Wound Care Center staff or if it gets dirty or wet.
• Do not put anything into an open wound that is not prescribed by your physician.
• Change your dressing as close to hand washing facilities as possible.

Storing Your Dressing Supplies

• Always keep your clean dressings in a storage container that has a lid and is kept off of the floor away from children and pets. A plastic container with a lid or clean large plastic bag that can be tied shut will be best.
• When preparing a clean working area, use a paper towel or other clean cover to put your supplies on. DO NOT put supplies directly on a table or bed.

The Proper Way to Wash Hands

• Remove your jewelry before washing your hands so that the spaces between your fingers can be cleaned and dried.
• Adjust the water temperature and lather your hands with soap.
• Rub your hands together, cleaning the front and back of each hand up to the wrist and between all fingers for 20 seconds (sing the Happy Birthday song 2 times or the chorus of Yankee Doodle is about 20 seconds).
• Rinse well.
• If possible, turn the faucets off with a paper towel or towel.

Advanced Treatment Modalities

Advanced wound care therapy includes several innovative treatment options. Negative pressure wound therapy uses controlled, gentle suction to remove excess fluid, reduce swelling, and stimulate new tissue growth. This treatment can significantly accelerate healing in many types of wounds.

For certain wounds, specialized treatments like bioengineered skin substitutes provide a temporary covering that supports your body’s natural healing process. These advanced products help create an ideal environment for new tissue development.

In specific cases, hyperbaric oxygen therapy may be prescribed to increase oxygen levels in your body’s tissues. This treatment can be particularly beneficial for wounds that are slow to heal due to poor circulation or certain medical conditions.

Taking the Next Step: Creating Your Ulcer Care Plan

Working closely with your healthcare team is the first step in managing your wound care effectively. They will develop a personalized treatment plan, including specific cleaning methods, dressing types and change schedules tailored to your wound’s needs.

Track your progress by keeping detailed notes of your daily wound care routine. Document any changes in the wound’s appearance, drainage, or surrounding skin, and maintain a record of when dressings are changed. Taking photos (if recommended) can help monitor healing over time.

Stay connected with your healthcare team through regular follow-up appointments and reach out immediately if you notice concerning changes. Your observations and documentation help them adjust your treatment plan as needed to ensure optimal healing.

At Healogics, we’re here to support you on your healing journey. Our wound care specialists are dedicated to providing expert care and guidance every step of the way. Contact your nearest Wound Care Center to learn more about creating your personalized wound care plan. Please click here to find a Healogics Wound Care Center® near you.

Remember, successful wound healing is a partnership between you and your healthcare providers. With proper coordination and careful monitoring, you can work together toward the best possible outcome.

References
Bryant, R. & Nix, D. (2007). Acute & chronic wounds: current management concepts (3rd ed). St. Louis: Mosby.
Krasner, D., Rodeheaver, G. & Sibbald, R.G (Eds) (2007). Chronic wound care: a source book for healthcare professionals (4th ed.) Malvern: HMP