What makes a wound chronic
A wound is considered chronic or non-healing when it has not progressed meaningfully toward closing within about four to six weeks of appropriate care. The wound is usually stuck in the inflammatory phase, unable to move forward into building new tissue. The reason is rarely the wound surface alone; it is almost always something underneath, poor circulation, uncontrolled diabetes, persistent pressure, infection, inadequate nutrition, or a combination.
Why finding the cause matters more than changing the dressing
The most common mistake with a stalled wound is cycling through dressings while the actual barrier goes unaddressed. A wound will not heal over dead tissue that needs debridement, on a foot that is not offloaded, in a leg without adequate blood flow, or in a patient whose nutrition cannot support tissue repair. Palm's approach is to identify and address the specific driver, which is where the primary-care and wound-care combination is most useful.
The factors that most often stall healing
- Inadequate blood supply to the wound area
- Uncontrolled diabetes affecting circulation and immune response
- Ongoing pressure or friction on the wound
- Undertreated infection or biofilm on the wound bed
- Insufficient protein and calories to build new tissue
When to escalate
A wound that is enlarging, developing increased drainage or odor, showing spreading redness, or exposing deeper structures needs prompt evaluation and often specialty referral. A chronic wound that suddenly changes character is signaling that something has shifted and should not wait for a routine appointment.