4 Stages of Pressure Ulcers and Bedsores Explained

As noted in the U.S. Library of Medicine at the National Institutes of Health, the amniotic membrane used in the HealPrecisely treatment regimen can be a valid source for wound healing.  The Study, published in 2016, followed two groups of patients with chronic leg ulcers.  Group I was the control group and included 11 patients treated using conventional wound dressings that were changed daily for eight weeks.  Group II consisted of 14 patients treated by placing an amniotic allograft over the ulcer, which was held in place with a secondary dressing.  The allografts and dressings were changed daily.  After 60 days of treatment, Group I showed no reduction in the size of their ulcers and had no relief for their pain.  Group II, on the other hand, complete healing occurred within 14 to 60 days for all 14 patients in the study.  Eleven of the 14 patients reported improvement in their pain level as well.An article released by the International Wound Journal in 2020 compiled data from 257 articles, including articles on patient research using amniotic allografts.  Patients were suffering from Diabetes mellitus, one of most serious, chronic, non-communicable diseases worldwide, and is currently the seventh leading cause of death worldwide.  They found that the proportion of wound healing using human amniotic membranes was significantly higher than those who received conventional wound dressings alone.  Those receiving the kind of care HealPrecisely offers had a 95 percent improvement in just six weeks.Europe PMC released a literature review entitled Amniotic Membrane Adjuncts and Clinical Applications in Wound Healing in 2018.  Following data from studies conducted between 2013 and 2017, they concluded that amniotic allografts were beneficial in the setting of difficult-to-heal fistulas and effective in treating diabetic and venous ulcers when combined with standard therapy.We know this treatment has the power to change lives, said Jennifer Rivard, HealPreciselys COO.  Weve seen amazing outcomes from patients who had little or no hope to be wound-free.  This therapy is truly life-changing.To read these studies and others, visit our research page.

Wounds are a natural part of life, typically healing on their own with proper care and attention. However, some wounds defy the bodys natural healing processes, persisting despite treatment efforts. A non-healing wound, also known as a chronic wound, poses significant challenges to both patients and healthcare providers. In this article, well explore the tell-tale signs of non-healing wounds, delve into their causes, and discuss innovative treatments and diagnostics aimed at addressing this issue. What Is a Non-healing Wound?A non-healing wound is a wound that fails to progress through the normal stages of healing within a reasonable time frame. According to Yale University, that reasonable time frame is between four to six weeks. While acute wounds typically show signs of improvement within a few weeks, chronic wounds may remain stagnant or worsen over time. Examples of chronic wounds include diabetic foot ulcers, pressure ulcers, venous ulcers, and arterial ulcers. These wounds can result from several factors, including diabetes, poor circulation, immobility, and trauma. Causes of Non-Healing WoundsFollowing are some of the most common conditions that can lead to the development of non-healing wounds.Poor Blood CirculationAdequate blood flow is essential for delivering oxygen and nutrients to the wound site and removing waste products. Conditions such as peripheral artery disease (PAD) and venous insufficiency can impair blood circulation, hindering the bodys ability to heal wounds.Woman testing her blood sugar level at home.DiabetesDiabetes can lead to peripheral neuropathy (nerve damage) and peripheral vascular disease (blood vessel damage), increasing the risk of foot ulcers and impairing wound healing. Elevated blood sugar levels can also interfere with the bodys inflammatory response to immune function, further complicating the healing process.PressureProlonged pressure on the skin can cause tissue damage and lead to the formation of pressure ulcers, commonly known as bedsores. Individuals who are bedridden or confined to a wheelchair are particularly susceptible to pressure ulcers, which can be challenging to heal due to constant pressure on the affected area.InfectionWounds that become infected are less likely to heal properly, as bacteria can impede the bodys natural healing processes. Chronic wounds are especially prone to infection, as the compromised tissue provides an ideal environment for bacterial growth. Infections can lead to delayed wound healing, increased pain, and systemic complications if left untreated.Underlying Health ConditionsCertain underlying health conditions, such as autoimmune disorders, cancer, and malnutrition, can impair the bodys ability to heal wounds. These conditions often weaken the immune system, disrupt normal physiological processes, and interfere with tissue repair mechanisms, thus prolonging the healing process. What Are the Stages of a Healing Wound?Before we look at the signs of a non-healing wound, lets look at the stages all wounds go through on their way to being healed.There are four stages of wound healing  Hemostasis, inflammatory, proliferation, and maturation. Here are the signs that will help you recognize whether a wound is healing normally:Bleeding or ScabbingTypically, wounds like burns and pressure ulcers do not bleed. If its a cut, scrape, gash, or puncture wound, it goes through three stages bleeding, clotting, and scabbing. This is called haemostasis, which begins within seconds of the wound occurring.A healthy response to cuts and scrapes is that the wound will bleed and begin to clot within a few minutes. After the blood begins to dry, there will be scabbing. But if the wound is bleeding after a significant period or you cant stop the bleeding, stitches may be required to close the wound. If there is no scabbing after a while, you need to seek treatment from a wound care expert.Swelling After the scab formation, the bodys immune system starts healing the wound in the form of swelling, or tendering. The inflammation or swelling is a sign that the bodys immune system is working properly and repairing your wound. You may notice drainage from the wound. It may have a reddish or pinkish appearance, enabling sufficient blood flow, oxygen, and nutrients to the affected area. This usually occurs within 0 to 4 days of when the patient receives the wound. Growth of New Tissues In 2 to 24 days from the wounds appearance, proliferation occurs. When the swelling is stopped, the tissues will begin forming over the wound. That can last a couple of weeks in case of minor wounds. This is when the body repairs broken blood vessels and replaces damaged tissues. In the healing process, the skin pulls the wound edges inward, and it will get smaller.Scar indicate the final stages of wound healing.Scarring Scaring typically happens within 24 days to 1 year from the wound occurring. This is the last stage of wound healing. This can last anywhere from a few weeks to a whole lifetime. There will be a scar in the place of the initial scab. If the injury is minor, the scar will slowly fade away. You may also experience itching during this stage. If the wound is significant and is in a visible location, some seek plastic surgery to repair scar tissue.5 Signs of a Non-Healing WoundNow that we know what a properly healing wound looks like, here are the five main warning signs that a wound isnt healing.Sign #1: Thick Discharge of Yellow or Green Pus. Excessive pus or drainage from a wound can indicate infection, particularly if the discharge is thick and yellow or green in color. Pus is a sign that the body is fighting off bacteria present in the wound, and its presence may delay the healing process if not addressed promptly. Sign #2: Redness or Warmth Around the WoundPersistent redness or warmth in the skin surrounding the wound can indicate inflammation and infection. Inflammatory mediators released by the body in response to infection can cause the skin to appear red and feel warm to the touch. This inflammatory response may impede wound healing and require targeted intervention.Sign #3: Unpleasant OdorA foul or malodorous smell emanating from the wound is often indicative of bacterial infection and tissue necrosis. The breakdown of tissue by bacteria produces volatile organic compounds (VOCs) that contribute to the characteristic and unpleasant odor of infected wounds. Addressing the underlying infection is essential. Sign #4: SwellingSwelling, or edema, around the wound site can impede blood flow and hinder the delivery of oxygen and nutrients to the tissues. Chronic inflammation and impaired lymphatic drainage contribute to fluid accumulation in the affected area, further exacerbating the swelling. Managing edema is crucial for optimizing wound healing outcomes and preventing complications.Sign #5: Darkening of the Skin Around the WoundDarkening or discoloration of the skin surrounding the wound, known as periwound maceration, can occur due to prolonged moisture exposure and impaired tissue oxygenation. Macerated skin is more susceptible to breakdown and infection. Proper wound dressing selection and moisture management are essential for preventing periwound maceration and promoting healing. In addition to these signs, systemic symptoms such as fever, chills, and malaise may indicate a severe infection or systemic inflammatory response requiring urgent medical attention. Factors Affecting Wound HealingFactors affecting wound healing can be extrinsic or intrinsic. Wound care teams must address all of these factors to see success in healing chronic wounds.Extrinsic Local FactorsWound management and moisture balance (e.g. wound dehydration or maceration)Stable temperature (approximately 37oC)Neutral or acidic pHPresence of infectionWound locationMechanical stress, pressure, or frictionPresence of foreign bodiesGood nutrition plays an important role in healing chronic wounds.Intrinsic Systemic FactorsNutritionUnderlying or chronic diseaseLimited mobilityImpaired perfusionMedications (including immunotherapy, chemotherapy, radiation, or NSAIDs)Mental health (including stress, anxiety, or depression)Patient understanding and complianceAge of patientBest Wound Care PracticesImproving the healing rate and patient outcomes for non-healing wounds requires a comprehensive approach to wound care. Here are some of the best practices to consider.DebridementDebridement is the process of removing necrotic tissue, foreign material, and biofilms from the wound bed to promote healing. Sharp debridement, mechanical debridement, enzymatic debridement, and surgical debridement are among the techniques used to facilitate wound healing. Debridement helps create a clean wound environment conducive to tissue repair and reduces the risk of infection. IV antibiotics can help treat bacterial infections in non-healing wounds.AntibioticsAntibiotics may be prescribed to treat bacterial infections associated with non-healing wounds. Topical antibiotics, oral antibiotics, or intravenous antibiotics may be used depending upon the severity of the infection and the patients overall health status. However, antibiotic stewardship is essential to prevent the development of antibiotic resistance and minimize adverse effects.Advanced Wound Care Procedures and Diagnostic ToolsAdvanced wound care procedures such as amnion allografts, near-infrared spectroscopy, low-frequency ultrasound, and fluorescence imaging offer innovative solutions for promoting wound healing and monitoring treatment progress. These technologies enable clinicians to assess wound characteristics, optimize tissue oxygenation, and target interventions effectively.The most advanced wound care tools and treatments available include Negative Pressure Wound Therapy (NPWT). Also known as vacuum assisted closure, the provider applies controlled negative pressure to the wound using a specialized dressing and vacuum system. This is particularly useful for large, deep, or complex wounds.Biological and cellular therapies like autologous skin grafts, allografts, xenografts, bioengineered skin substitutes, and growth factors work to provide a scaffold for cellular activities. Some of the most advanced diagnostic tools available in wound care today include the Mimosa multispectral near-infrared spectroscopy for low-frequency ultrasound which promotes healing through dilating blood vessels and speeds healing. Another innovative tool is MolecuLight, a device that provides highly accurate real-time information on harmful bacteria that are often present in wounds. XSONX is a vibrating mechanical debridement tool (VMDT) which uses low sonic level frequency vibrations to scrub and debride wounds often with less pain and better results.Nurse applies a bandage to help ensure a moist environment for the wound.Proper Wound DressingChoosing the appropriate wound dressing is crucial for maintaining a moist wound environment, managing exudate, and protecting the wound from contamination. A wide range of wound dressings is available, including hydrocolloids, foams, hydrogels, and alginates, each offering unique benefits depending on the wound type and nature of the wound. Regular assessment and reassessment of the wound and dressing are essential to ensure optimal healing outcomes. Compression therapy is ideal for managing venous leg ulcers or edema-related wounds. It involves the application of graduated compress through compression bandages, compression stockings, or compression wraps to improve venous return, reduce swelling, and encourage healing. Surgical InterventionsIn some cases, skilled wound care surgeons conduct wound debridement, closure with sutures or staples, skin grafts or flaps, or the removal of non-viable tissue. Heal Precisely can treat even the most stubborn wounds in the comfort of a patients home or care facility.Mobile Wound CareClinics like HealPrecisely have mobile care clinics that can be bring treatments directly to the patient. A perfect option for people with mobility challenges, mobile care clinics are staffed by a wound care team, the latest in diagnostic tools, and able to allow our clinicians to deliver a superior care experience wherever our patients need us.Consultation With a Wound Care SpecialistFor complex, non-healing wounds that do not respond to conventional treatments, consultation with a wound care specialist or multidisciplinary team can help resolve even the hardest-to-heal wounds. Wound care specialists have expertise in managing challenging wounds and can recommend advanced treatment modalities tailored to the individual patients needs.Non-Healing Wounds Represent a Significant Health Challenge, but They Can Be Healed With the Right Tools and ExpertiseBy understanding the signs of non-healing wounds, addressing underlying causes, and implementing best wound care practices, healthcare providers can improve patient outcomes and enhance the quality of life for individuals suffering from chronic wounds.Through ongoing research and innovation, the field of wound care continues to evolve, offering hope for those grappling with this complex and debilitating condition. At HealPrecisely, we are pioneers in making breakthrough therapies and diagnostic tools available to our patients faster than other wound care clinics. Thats why we have healing rates of 98.05%, which is 6% higher than the national average, according to EHR Healthnet.If you, someone youre treating, or someone youre caring for has a chronic wound that wont heal, we can help. To learn more, visit www.HealPrecisely.com. 

Its no secret that caregiving is a deeply compassionate role, but the job also comes with significant emotional and physical challenges. The stages of caregiver burnout, also known as caregiver strain or burden, occur when the demands of caregiving gradually lead to exhaustion, anxiety, and emotional fatigue. Especially for those who routinely treat patients with chronic wounds, care can seem like an uphill battle and make even the most hopeful caregivers feel hopeless at times. Whether you are a professional caregiver or you are overseeing a loved one, understanding the stages of caregiver burnout is the key to manage and recover from it. What Is Caregiver Burnout?Caregiver burnout happens when individuals who provide routine care to those with declining health become overwhelmed, both physically and mentally. Common symptoms include:Extreme fatigueIrritabilityAnxietyDepression Loss of sleepMood swingsFrequent headachesMental haze, sometimes dizziness Over 60% of caregivers report caregiver strain at some point in their career, and the impact of unrecognized burnout can be detrimental to both the caregiver and the patient. For this reason, its extremely important to recognize the 4 stages of caregiver burnout so steps can be taken to improve the mental state before complete burnout takes place. What Causes Caregiver Burnout? This phenomenon is often complex and builds up in layers over the caregivers career. Typically, a professional caregiver enthusiastically begins their role to help their patients overcome mental and physical challenges. However, after seeing some of their patients hit unexpected roadblocks, experience an out-of-the-blue decline in health, or even experience a patients death, they may begin to feel a responsibility on their shoulders that they are the ones that must solve all of their patients problems. After all, its common for caregivers to form strong bonds with the patients that they love so much. Its only natural to feel defeated when a beloved patient regresses in their treatment. Unfortunately, this often leads to the common stages of caregiver burnout, a spiral that has a snowball effect on the caregivers life.The 4 Stages of Caregiver Burnout Overall, there are 4 main stages of caregiver burnout that are worth investigating. They include the warning stage, the control stage, the survival stage, and the burnout stage. Keep reading to uncover the secrets of the stages of caregiver burnout. 1. Initial Caregiver Strain (Warning Stage)In the beginning, caregiving may feel rewarding. Caregivers often start with high energy and motivation, thinking they can meet all the needs of their loved one or patient. However, as responsibilities increase and caregiving becomes a long-term role, the initial optimism may wear off. This is known as the warning stage. A caregiver will begin to feel signs of strain in their relationship with their career. They may start to feel fatigue and frustration, especially when they think about their job or certain patients. 2. Development of Anxiety (Control Stage)As the physical and emotional demands grow, caregivers often feel overwhelmed. The duties take longer to complete and emotional tolls, such as feelings of helplessness or guilt, may emerge. Enter the next stage of caregiver burnout: the control stage.Anxiety may develop, with caregivers sometimes feeling resentful or worried that they are not doing enough. This is a slippery slope because many caregivers will try to control situations that are out of their control, only leading to more pain and anguish when the treatment or patient interaction does not go as planned. 3. Escalation of Caregiver Challenges (Survival Stage)At this point, the weight of caregiving begins to feel unbearable. Emotional detachment or withdrawal from loved ones is common, and caregivers may begin to neglect their own health. This is referred to as the survival stage. Depression, physical exhaustion, and a sense of being trapped may set in. Without intervention, this stage can lead to severe emotional and physical consequences for the caregiver.Unfortunately, as the caregiver becomes more and more exhausted, their level of enthusiasm and care towards their patients may also begin to drop. This can lead to a poorer standard of patient care. For caregivers who are in this stage of caregiver burnout, isolation from loved ones will only burden the caregiver more. They must reach out to friends and family for help.4. Complete Burnout (Burnout Stage)In the final stage of burnout, caregivers are no longer able to provide effective care. They may experience emotional numbness, an inability to empathize with the person in their care, and even physical breakdown. Sadly, many caregivers in this position may not even feel like they can adequately take care of themselves. An oppressive burden may sit on their shoulders, causing them to become depressed and isolated.This is the most severe stage and requires immediate intervention to prevent long-term damage to both the caregiver and the person receiving care. Caregiver Burnout in Chronic Wound Care SpecialistsWhen it comes to wound care specialists, many caregivers and healthcare professionals may experience the stages of caregiver strain as their career progresses. Its not uncommon for a patient with a chronic wound to see signs of healing, and then an unexpected challenge causes the healing process to reverse. This can be extremely stressful and frustrating for the wound care specialist.Common Challenges Faced By Wound Care SpecialistsAlong with everyday road bumps, wound care specialists also experience:Extended duration of care: Chronic wounds can last years if theyre not treated properly.Unpredictable fluctuations in health: Patients with chronic wounds often experience unpredictable health changes. Caregivers must be prepared to handle sudden deterioration or complications like infection, which can lead to constant vigilance and heightened anxiety.The emotional burden of managing persistent pain and suffering: Chronic wounds often involve continuous pain or discomfort, which caregivers witness daily. This can lead to feelings of helplessness and emotional strain, as caregivers feel incapable of alleviating the patients suffering.Isolation: Caregivers of patients with chronic conditions often report feelings of isolation, as the chronic nature of the condition limits social interactions. Caregivers may feel misunderstood by those who are not experiencing caregiving.Financial strain: Chronic wounds often require ongoing medical care, equipment, and supplies, placing significant financial pressure on caregivers. Balancing work, caregiving, and financial responsibilities are further strained when time-intensive treatments like hyperbaric therapy are prescribed that require long hours of treatment every day and transport to and from access to the hyperbaric chamber. At the end of the day, managing chronic wounds can involve physically and emotionally demanding tasks. These include complex wound dressings, lifting the patient, or ensuring they maintain hygiene, all while helping the patients emotional state throughout the healing process. Over time, these tasks can lead to burnout or even physical injury, especially if proper resources or support systems are lacking.How Long Does It Take To Recover From Caregiver Burnout?Recovery from caregiver burnout is not an overnight process. It varies depending on the individual and the severity of the burnout. Some caregivers may recover in a few weeks once they seek support and implement self-care strategies. Meanwhile, others might need several months, especially if they are dealing with major emotional and physical recovery.Practical Tips for Caregiver Burnout RecoveryHere are some quick and simple tips to help caregivers recover from strain or burnout. Keep in mind that all of these steps can be used as helpful tools at any stage of the burnout process. 1. Prioritize Self CareEngage in regular physical activity, maintain a balanced diet, and ensure you get enough sleep. Prioritize time dedicated to your favorite interests or hobbies that allow you to focus on activities other than healthcare. Even short breaks throughout the day can help alleviate stress. 2. Seek Professional SupportTherapy or counseling can help caregivers process their emotions and develop coping strategies to prevent burnout in the future. If you have experienced a deep-cutting emotional event in regard to a patient, such as a patients death, it is important to express your feelings. Never bottle them up! A professional therapist is a great way to open up about what you are experiencing. 3. Use Respite CareProfessional respite care services can give caregivers a much-needed break while ensuring their loved ones receive appropriate care. This is a great way to manage burnout symptoms and work through difficult times in your career.4. Build a Support NetworkJoining support groups or seeking help from family and friends can reduce the isolation that caregivers often feel. This is super important! Never underestimate the love and help you will receive from friends, family, neighbors, and community groups.By recognizing the signs of burnout early and taking proactive steps, caregivers can recover and continue to provide care sustainably. Caregivers must remember that their well-being is just as important as the care they give!HealPrecisely Heals Chronic Wounds FasterAt HealPrecisely, we help chronic wound care specialists lessen their odds of caregiver burnout. First, our team uses advanced wound care therapies to help patients heal faster, in less than half the time of the national average. While we provide the most advanced therapies in the wound healthcare industry today like allografts and negative pressure wound therapy, more than half of our patients dont require them and can be treated through other innovative and proven ways. Equally important, we can come to the patients bedside, helping caregivers recover precious time in their busy schedules. All of these factors allow our wound care specialists to enjoy more success with their patient outcomes, leading to a higher satisfaction rate among healthcare professionals and patients alike!