Brief Answer:
Wound management, multidimensional .

Detailed Answer:
Thank you for asking

I read your question and i understand your concern. Non-healing wounds have traditionally been defined as those that fail to progress through an orderly sequence of repair in a timely fashion. Such wounds are sometimes thought of as being caused by neglect, incompetence, misdiagnosis, or inappropriate treatment strategies.

Regarding best treatment of a non healing wound it needs multidirectional approach.

1) Assessment and management of entire body:
Any body disease or illness that can compromise wound healing and nutritional status can complicate and delay wound healing. Metabolic disorders like diabetes mellitus, hypothyroidism or blood disorders like anemia, polycythemia etc, lung disorders like asthma, COPD which compromises adequate oxygen and nutrition both are necessary for the wound healing. So control of any body illness and its management is first step in proper wound healing.

2)Adequate Oxygenation : is the next important step. Local vasoconstriction of vessels, blood volume deficits in extremities due to sympathetic overactivity causes this . Viability of the tissue and removal or any dead necrotic patches is mandatory for a best wound care.

3) Nutrition is next main step. Take 1.25 to 1.5 gm of protein per kg of body weight and aim for calories of 35 kcal / kg of body weight in a day. Vitamins supplementation specially A, C, E and zinc is necessary.

4) Removal of foreign body from the wound.

5) Plain radiographs of the wound to rule out osteomyelitis.

6) Keeping the wound clean, regularly dressed, viable.

7) Debridement of dead necrotic patches.

8) irrigation of the wound with saline water, you can make at home, one gallon of distilled water and 8 tea spoons of salt water and boil and then cool at room temperature before use.

9)Provide a moist wound best with any over the counter available moist dressings like isotonic sodium chloride gel (eg, Normlgel [Scott Health Care], IntraSite gel), or a hydroactive paste (eg, DuoDerm [ConvaTec]).

10) Topical application of platelet derived growth factors like Becaplermin gel 0.01% (Regranex) helps.

Consult a wound care specialist and let them run some swabs to sort out organisms or infection and treat that with antibiotics accordingly. Also every non healing open wound should be biopsied to be on the safer road. Talk to your doctor and let them decide what is best for you.

I hope it helps. Take good care of yourself and your wound and don't forget to close the discussion please.

Regards
Khan

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