A non-healing wound, also called a chronic wound, is a wound that has not healed after about four weeks of care. It stays open, stalls, or gets worse instead of closing. Most non-healing wounds have an underlying cause that has to be treated first.
Watch for these signs that a wound needs medical attention:
- The wound has not gotten smaller in two weeks
- Redness spreading outward from the edges
- Pain that is increasing rather than easing
- Thick or cloudy drainage, or drainage with an odor
- Skin around the wound feels warm or hot
- Fever or chills
- Dark, gray, or black tissue inside the wound
- A wound that closes and then opens again
Fever, chills, or redness spreading quickly can signal a serious infection. Call the treating physician right away or go to an emergency department.
Why won't my wound heal?
A wound won’t heal when something is blocking the body’s normal repair process, most often poor blood flow, infection, constant pressure, or an untreated medical condition.
Healing depends on oxygen, food, and clean tissue reaching the wound. When any of those are missing, the wound stalls. Common causes include:
- Poor circulation, which limits the oxygen reaching the tissue
- Infection, including bacteria that form a protective layer over the wound bed
- Diabetes and high blood sugar, which slow repair and reduce sensation
- Constant pressure on one area of skin, common during long hospital stays
- Low protein levels or poor nutrition
- Swelling in the legs that keeps fluid trapped in the tissue
- Certain medicines, including steroids and chemotherapy
- Smoking, which narrows blood vessels
- A weakened immune system
More than one cause is usually at work at once. That is why treating only the wound surface rarely fixes it.
What counts as a non-healing or chronic wound?
Doctors usually call a wound chronic when it has not healed within about four weeks. Some use a longer window of up to twelve weeks, based on the wound.
The National Institutes of Health guidance on chronic wounds uses a window of four to twelve weeks, and its review of how wound healing works sets the shorter four-week mark.
The exact timing matters less than the pattern. A wound that keeps shrinking is healing, even if it is slow. A wound that looks the same week after week has stalled.
Wounds that commonly become chronic include:
- Pressure injuries, sometimes called bed sores
- Diabetic foot ulcers
- Venous leg ulcers caused by poor vein circulation
- Arterial ulcers caused by blocked arteries
- Surgical wounds that reopen after closing
- Wounds that develop during a long stay in intensive care
How to treat wounds that won't heal
Non-healing wound treatment works in two parts: caring for the wound itself and correcting the underlying problem that keeps it open.
A wound care team works through these steps:
- Assessment and testing. The team measures the wound, checks blood flow to the area, and takes swabs if infection is likely.
- Removing dead tissue. Dead tissue blocks healing and feeds bacteria. Clearing it, a process called debridement, gives healthy tissue room to grow.
- Controlling infection. Antibiotics may be given by mouth or through an IV, guided by lab results rather than guesswork.
- Choosing the right dressing. Different wounds need different dressings to control moisture, protect new tissue, and cut bacteria.
- Negative pressure wound therapy. A sealed dressing attached to a gentle vacuum pump draws out fluid and helps the wound edges pull together.
- Relieving pressure. Special mattresses, cushions, set turning times, and padded footwear keep weight off the wound.
- Improving nutrition. Protein levels are checked and corrected, since the body cannot rebuild tissue without the right building blocks.
- Treating the underlying condition. Blood sugar control, better blood flow, and less swelling often decide whether the wound closes.
- Surgery when needed. Some wounds need surgical repair, a skin graft, or a procedure to restore blood flow.
Which wounds need hospital-level care?
A wound needs hospital-level long term acute care when the patient is too medically fragile for outpatient visits, or when the wound requires daily assessment and around the clock nursing.
Outpatient wound clinics work well for patients who are stable and can travel to visits. Hospital care is the better choice when:
- The infection has reached deep tissue or bone
- The patient is recovering from critical illness or a long intensive care stay
- There are several wounds, or wounds combined with other active conditions
- The patient is on a ventilator or receiving dialysis
- Dressing changes are complex and needed more than once a day
- Intravenous antibiotics are required
- The wound has not improved despite consistent outpatient treatment
What does inpatient wound care involve?
Inpatient wound care means the patient stays in the hospital with around-the-clock nursing, daily checks by certified wound specialists, and fast treatment when problems appear.
At RML Specialty Hospital, chronic wound care is led by certified wound, ostomy, and continence nurses, guided by board-certified doctors. The wider team includes dietitians, pharmacists, physical and occupational therapists, and a physician assistant.
The team looks past the wound itself. Diet, blood protein levels, and the patient’s ability to fight infection all shape the plan. Progress is watched closely, so treatments can be changed rather than repeated without result.
This approach matters most for patients with several conditions at once. RML’s medically complex care program coordinates wound treatment alongside pulmonology, infectious disease, nephrology and cardiology, and works together with the ventilator weaning program when breathing support is also needed.
Where RML fits
RML Specialty Hospital provides hospital-level wound care at two Illinois campuses, one in Chicago and one in Hinsdale.
The Hinsdale campus serves families across DuPage County and the western suburbs. The Chicago campus serves the wider metro area. RML takes referrals from hospitals and care centers across the region, and the clinical team reviews each case to confirm hospital-level care is the right fit.
Learn more about the advanced wound care program at RML, find contact details for the Chicago and Hinsdale locations, or read what to expect through the admissions process for families.
Frequently asked questions
Why won't my wound heal?
A wound won’t heal when poor blood flow, infection, constant pressure, poor diet or an untreated illness such as diabetes blocks the body’s repair process. Usually more than one cause is at work, so the root problem has to be found and treated along with the wound.
How do you treat a wound that won't heal?
Treatment combines clearing dead tissue, controlling infection, using the right dressing, taking pressure off the area, and improving diet. At the same time, the team treats the root cause, such as poor blood flow or high blood sugar. Some wounds also need surgery.
What is a non-healing wound?
A non-healing wound, also called a chronic wound, is a wound that has not healed after about four weeks of proper care. Instead of closing, it stays the same size or grows. Bed sores, diabetic foot ulcers and leg ulcers are common examples.
When should someone see a wound care specialist?
See a wound care specialist if a wound has not shrunk much after two to four weeks, if pain or drainage is increasing, or if there are signs of infection such as spreading redness, warmth or fever. An early check gives the best chance of healing.
What happens if a wound never heals?
An untreated wound can lead to deep infection, bone infection, tissue loss and, in severe cases, the loss of a limb. It also causes lasting pain and limits movement. Specialist care greatly improves the chance of healing, which is why early referral matters.
Can a hospital treat a wound that won't heal?
Yes. Hospital care adds around-the-clock nursing, daily checks by a specialist, IV antibiotics, and coordinated support from the diet, therapy, and infection teams. It suits patients who are medically fragile or whose wounds have not improved with outpatient care.
Is an LTACH the same as a nursing home?
No. An LTACH is a licensed hospital with doctors on site daily and nurses trained in critical care. A nursing home is a place to live with help for daily needs. The two meet very different needs and follow different rules.
Getting help in Chicago and the western suburbs
Families searching for a wound care hospital in Chicago or the western suburbs are often told outpatient visits are no longer enough. RML Specialty Hospital gives inpatient wound care at its Chicago and Hinsdale campuses for patients who need hospital-level treatment.
More than 65 hospitals across Illinois, Indiana, and Wisconsin refer patients to RML. Founded in 1987, RML is a not-for-profit hospital with doctors on site 24 hours a day.
Chicago campus: 3435 West Van Buren Street, Chicago, Illinois 60624. General information: 773-826-6300. Admissions 773-826-6400.
Hinsdale campus: 5601 South County Line Road, Hinsdale, Illinois 60521. General information: 630-286-4000.
Every wound is different. Talk with the treating physician about whether hospital-level wound care is right for your loved one.
