How to tell if a scratch or a bump could turn into a chronic wound

Jul 12, 2019
Common cuts or grazes can turn into something far more sinister, which is why Boomers need to pay particular attention to their wounds. Source: Getty

While everyone suffers a scratch, cut or bump from time to time, experts are warning older people to pay more attention to their wounds – given they’re more at risk of small injuries turning into chronic wounds than other age groups.

Each year in Australia, $3 billion is spent on wound treatment in hospitals and aged care facilities, with more than 500,000 Aussies suffering in silence daily because of chronic wounds. While surgical wounds, small cuts and bruises may seem like a normal part of daily life, many factors put older people at risk of these wounds becoming more problematic.

Professor Fiona Wood, director of the Burns Service of Western Australia, 2005 Australian of the Year and Wound Awareness Week ambassador, treats burns victims daily and knows all too well the importance of acting quickly when a wound first appears.

“When we get over 60, burns aren’t anywhere near as easy to deal with,” she tells Starts at 60. “Even small burns and injuries of the skin can have a really profound impact.

“As we get older, those cuts and bruises can turn into a chronic wound all too easily – especially on the lower leg, especially in a situation where you’ve got diabetes, if you’re a smoker or if you’re overweight,” Wood explains.

The skin has more difficulty healing as we grow older because it becomes thinner and the immune system that assists in the healing process slows down, while health issues including diabetes and vascular disease can also impact it. This means a small graze or cut that would’ve healed within a week when we were younger can take much longer.

“Because it takes longer, we’re more vulnerable to the wound extending and then it starts to become a real problem,” Wood says. “The elderly in our community, there’s a significant number who suffer from these chronic wounds.”

Part of the reason why so many older people develop chronic wounds is because they simply ignore the issue, don’t take wounds seriously or think they will just go away on their own.

Read more: Managing paper-thin skin and preventing skin tears

“We can be too stoic sometimes. If the wound isn’t getting better each day, if it’s getting worse, absolutely that’s a red flag,” Wood explains.

If a wound becomes red, swollen, hot or painful, bleeds regularly, becomes black or yellow, has yellowish fluid or an unpleasant smell, takes longer than a month to heal or fails to reduce in size, it’s becoming a chronic wound and needs medical attention.

“If you get attention early, then you can really avoid a whole lot of problems down the track,” Wood says. “I’m a great believer that prevention is better than cure.”

The first port of call should be your GP and generally if a wound hasn’t healed within a week or becomes worse in the first week, action should be taken. Treatment varies depending on the type of wound a person has, but health professionals will assess a patient’s overall health including their nutrition, heart function, blood supply, medication, other health issues and lifestyle factors to determine whether they’re contributing to the problem.

They also focus specifically on the wound by keeping it clean, controlling swelling through elevation and compression bandaging and prescribing antibiotics if a wound is infected.

“The dressings that we use these days are really advanced,” Wood says. “Right here and right now, there’s a lot more than can be done than was done 20 or 30 years ago.”

Healing tools and technology are also being developed at a rapid rate, but Wood says these types of advanced treatments are only required in the worst cases and can usually be avoided if people treat their wounds early.

“It’s great to be stoic and you don’t want to be running to your GP every second day, but you’ve got to listen to your body. You’ve got to be sensible about it,” Wood says.

With the average chronic wound sufferer spending $340 a month on treatments, dressings and painkillers, Wood also recommends daily moisturising and exercise to protect the skin and prevent chronic wounds from developing.

Read more: Airing wounds isn’t the right way to treat them, Dr Rochford says

“It’s really important as we get older that we keep active and keep moving,” she says. “It’s absolutely really important for your general health, but particularly for skin and circulation.”

Meanwhile, touching and massaging the skin may also reduce the risk of skin tears, with a 2014 study finding people in a nursing home who massaged Sorbolene cream into their skin twice a day reduced incidents of skin tears.

“It improved the integrity of the skin, improved the strength and improved the capacity of the skin to withstand the trauma, so bruises didn’t develop into wounds,” Wood says. “Touching the skin and massaging keeps the skin healthy.”

Do you know someone who’s been impacted by a chronic wound? How did they treat it?

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