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Chronic Wound refers to a wound that cannot heal within 4–6 weeks or has delayed tissue repair, causing continuous inflammation and risk of infection. These types of wounds often cause pain, disrupt daily life, and may lead to severe complications if not properly cared for. 
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Chronic wounds differ from common wounds that usually heal on their own within a few days or weeks. If not properly managed, these wounds may worsen, cause pain, disrupt daily activities, and lead to severe complications such as bloodstream infections, loss of limbs (e.g., amputation in diabetic patients), or even life-threatening conditions.
 
Causes of Chronic Wounds Chronic wounds often result from multiple factors combined, such as 
<ul>
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<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">Abnormal blood circulation leading to insufficient blood supply to the wound</li>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">Prolonged pressure such as pressure ulcers in bedridden patients</li>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">Infection that disrupts the wound healing process</li>
<li data-leveltext="" data-font="Symbol" data-listid="1" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">Wounds from accidents or surgery that do not heal normally </li>
</ul>
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<h2>Common Types of Chronic Wounds </h2>
1. Diabetic Ulcer Diabetic patients often develop wounds on their feet due to nerve damage causing loss of sensation, combined with narrowed blood vessels leading to insufficient blood supply. Small wounds may enlarge without notice. Improper care can lead to severe infections requiring amputation. 
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Key features: Wounds on the soles or toes, with hard edges, easily complicated by infection
 
2. Pressure Ulcer / Bedsore Caused by prolonged lying or sitting in the same position, especially in bedridden patients, leading to impaired blood flow to the subcutaneous tissue, resulting in ischemia and tissue necrosis. 
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Key features: Found at the sacrum, heels, hips, or bony prominences. The skin may change color, darken, and develop into deep wounds.
 
3. Venous Ulcer Occurs when the leg veins deteriorate, causing poor blood return to the heart and blood pooling in the lower legs, resulting in fragile skin and easy wound formation. 
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Key features: Usually located on the inner ankle, shallow and wide wounds with unclear edges, often with lymphatic fluid leakage.
 
4. Arterial Ulcer Different from venous ulcers, caused by narrowed or blocked arteries leading to insufficient blood supply and tissue oxygen deprivation. 
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Key features: Often found on the tips of toes or feet, small but deep wounds with sharp edges, very painful especially when walking or elevating the legs.
 
5. Infectious Ulcer Caused by chronic infections such as cutaneous tuberculosis, fungi, or certain bacteria. Without accurate diagnosis and treatment, wounds heal slowly and may recur. 
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Key features: Often have pus, redness, swelling, and may be accompanied by fever.
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<h2>Symptoms to Watch for in Chronic Wounds </h2>
<ul>
<li data-leveltext="" data-font="Symbol" data-listid="10" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">Wound does not improve or heal within 4–6 weeks</li>
<li data-leveltext="" data-font="Symbol" data-listid="10" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">Presence of pus, foul odor, fluid leakage, or repeated bleeding</li>
<li data-leveltext="" data-font="Symbol" data-listid="10" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">Red, swollen, hot wound edges or presence of necrotic tissue (black/brown)</li>
<li data-leveltext="" data-font="Symbol" data-listid="10" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">Increasing pain or, in some cases, no pain at all (e.g., diabetic patients with nerve damage)</li>
<li data-leveltext="" data-font="Symbol" data-listid="10" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">Numbness in the hands or feet along with wound problems</li>
<li data-leveltext="" data-font="Symbol" data-listid="10" data-list-defn-props="{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}" data-aria-posinset="1" data-aria-level="1">Fever or fatigue along with signs of infection</li>
</ul>
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<h2>Diagnosis </h2>
Doctors will perform a physical examination, take medical history, conduct blood tests, or may use special tests such as blood flow examination (Doppler Ultrasound), wound culture to identify infection causes, or X-rays or MRI if deep bone involvement is suspected.
 
<h2>Treatment Approaches </h2>
1. Appropriate wound care using medical materials that keep the wound moist and promote faster healing
2. Control of underlying diseases such as blood sugar control in diabetic patients
3. Use of antibiotics if infection is present
4. Surgery such as debridement or skin grafting
5. Hyperbaric Oxygen Therapy (HBOT) treatment with high-pressure oxygen to increase oxygen levels in tissues and accelerate wound healing
6. Wound healing technologies such as Negative Pressure Wound Therapy (NPWT)
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<h2>Prevention of Chronic Wounds </h2>
1. Regular foot and skin care
Check the skin daily, especially for diabetic patients, to observe for abrasions, blisters, or cracked skin. Keep feet and skin clean and dry after bathing. Use moisturizers to prevent dry, cracked skin.
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2. Control underlying diseases
Diabetic patients must control blood sugar levels within the range prescribed by their doctor. Those with vascular diseases should follow continuous treatment and take medications as prescribed. Avoid smoking and alcohol as they damage blood vessels and delay wound healing.
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3. Reduce risk from pressure
For bedridden patients, reposition every 2 hours to prevent pressure ulcers. Use air mattresses or cushions to reduce pressure on vulnerable areas such as heels and sacrum. Monitor skin in pressure areas; if redness or darkening appears, adjust position promptly.
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4. Promote blood circulation
Avoid sitting or standing still for long periods. When resting, elevate legs slightly to improve circulation. Engage in light exercise as appropriate, such as walking, swimming, or cycling. Wear medical compression stockings if you have venous disorders.
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5. Choose appropriate footwear and clothing
Shoes should fit well, not squeeze or rub the feet, especially for diabetic patients. Avoid walking barefoot in public or risky areas. Clothing should not be too tight as it may restrict blood flow.
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Chronic wounds not only affect quality of life but may also lead to severe complications if left untreated or improperly managed. Seeking examination and treatment from specialists is important to identify the true cause of the wound and plan appropriate individualized care.
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Phyathai Hospital 2 has a specialized team for chronic wound care, equipped with advanced treatment technologies, including surgery and comprehensive management of underlying diseases, to help wounds heal faster, reduce infection risk, and prevent recurrence.
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If you or someone close to you has a wound that does not heal within 4–6 weeks or shows signs of infection, you should promptly consult a specialist at Phyathai Hospital 2 for proper care from the early stages.

Chronic wounds are wounds that do not heal within 4–6 weeks, are at risk of infection, spread, and interfere with quality of life if not properly cared for. Therefore, you should see a doctor immediately for proper diagnosis and treatment.

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