Non-Healing Ulcers: A Case Study of a 70-Year-Old Patient

Father has a left foot ulcer?

Dear Dr.
Cheng,
My father is seventy years old and suffered a burn on his left ankle a few years ago that has not healed.
The small wound has now ulcerated into a wound approximately ten centimeters in diameter.
He does not have diabetes.
Should he be hospitalized? Is complete healing possible? I would greatly appreciate your guidance.
Thank you.
Sylee

Sylee, 30~39 year old female. Ask Date: 2001/06/03

Dr. Zheng Lizhen reply Dermatology

Without seeing the wound, it is impossible to make a judgment.
Please seek diagnosis and treatment from a nearby dermatologist or plastic surgeon.

Reply Date: 2001/06/03

More Info

Dear Sylee,
Thank you for reaching out regarding your father's non-healing ulcer. The situation you describe is concerning, especially given the size of the ulcer and the duration for which it has persisted. Non-healing ulcers can arise from a variety of factors, and understanding the underlying causes is crucial for effective treatment.

Firstly, it is important to recognize that even though your father does not have diabetes, there are other potential causes for chronic non-healing ulcers. These can include venous insufficiency, arterial insufficiency, pressure ulcers, infections, or even malignancies. Given that the ulcer has progressed to a significant size (approximately 10 cm in diameter), it is essential to have a thorough evaluation by a healthcare professional.

In many cases, hospitalization may be necessary for several reasons:
1. Wound Care: In a hospital setting, your father can receive specialized wound care, which may include debridement (removal of dead tissue), advanced dressings, and possibly negative pressure wound therapy. These interventions can significantly enhance healing.

2. Infection Control: If the ulcer is infected, intravenous antibiotics may be required. This is particularly important if there are signs of systemic infection, such as fever or increased redness and swelling around the wound.

3. Assessment of Underlying Conditions: A comprehensive assessment can help identify any underlying vascular issues that may be contributing to the non-healing ulcer. This may involve imaging studies like Doppler ultrasound to evaluate blood flow to the affected area.

4. Nutritional Support: Proper nutrition plays a vital role in wound healing. Hospitalization can ensure that your father receives adequate nutritional support, which may include supplements if necessary.

Regarding the potential for complete healing, it largely depends on several factors, including the underlying cause of the ulcer, the patient's overall health, and the effectiveness of the treatment plan. With appropriate medical intervention, many non-healing ulcers can heal, but this process can take time. Factors such as age, nutritional status, and the presence of other medical conditions can influence healing rates.

In addition to hospitalization, I recommend the following steps:
- Consult a Specialist: A referral to a wound care specialist or a vascular surgeon may be beneficial. They can provide targeted treatment options based on the specific characteristics of the ulcer.

- Regular Monitoring: Frequent follow-up appointments are essential to monitor the ulcer's progress and adjust treatment as necessary.

- Lifestyle Modifications: Encourage your father to avoid any activities that may further irritate the ulcer, such as prolonged standing or walking without appropriate footwear. Elevating the leg can help reduce swelling and improve blood flow.

- Pain Management: If your father is experiencing pain, appropriate pain management strategies should be discussed with his healthcare provider.

In conclusion, while the prospect of complete healing is possible, it will require a comprehensive approach involving medical evaluation, appropriate wound care, and possibly hospitalization. I encourage you to seek immediate medical attention for your father to address this serious issue effectively.

Best wishes for your father's recovery.

Sincerely,
Doctor Q&A Teams

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