How to Prevent Wound Recurrence: A Comprehensive Guide

Evidence-Based Strategies to Keep Your Wounds Healed 

If you’ve recently healed from a chronic wound, congratulations on reaching this important milestone. However, it’s crucial to understand that wound healing is often just the beginning of your long-term care journey. Research shows that nearly 40% of patients with healed lower extremity wounds will experience a recurrence within one year, with rates climbing to 60% at three years and 65% at five years. 

These statistics aren’t meant to discourage you, but rather to emphasize the importance of proactive prevention strategies. The good news is that many wound recurrences can be prevented with the right knowledge, tools, and commitment to ongoing care. By understanding your risk factors and implementing evidence-based prevention strategies, you can significantly reduce your chances of experiencing another wound. 

Early Detection: Your First Line of Defense 

One of the most effective ways to prevent wound recurrence is through regular self-monitoring and early detection of potential problems. Many wound recurrences begin with subtle changes that, when caught early, can be addressed before they develop into full wounds. 

Daily Skin Inspection Routine: 

• Examine your skin daily, paying special attention to areas where you’ve previously had wounds 
• Look for early warning signs such as redness, swelling, warmth, or tenderness 
• Check for calluses, blisters, or small breaks in the skin 
• Use a mirror or ask a family member to help inspect hard-to-see areas 
• Take photos of concerning areas to track changes over time 

Warning Signs That Require Immediate Attention: 

• New areas of persistent redness or discoloration 
• Swelling that doesn’t improve with elevation 
• Skin that feels unusually warm to the touch 
• New pain or tenderness in previously healed areas 
• Any break in the skin, no matter how small 
• Changes in skin texture or thickness 
• New calluses or areas of increased pressure

Managing Chronic Health Conditions 

Patients with chronic health conditions, such as diabetes or peripheral artery disease, should work with their healthcare provider to manage their condition and prevent further complications. The underlying conditions that contributed to your original wound are often still present after healing, which is why ongoing management is crucial. For individuals with diabetes, maintaining optimal blood sugar control is one of the most critical factors in preventing wound recurrence. High and fluctuating blood glucose levels can impair your body’s ability to heal and fight infection. 

Pressure and Friction 

Friction happens when you rub your skin on the sheets or skin on skin. Pressure relates to intense and/or prolonged force on a localized area of the body. Pressure and friction are two of the most common causes of wound recurrence, especially in areas where you’ve previously had wounds. The skin in these areas may be more fragile and susceptible to breakdown. Friction and pressure can cause the skin to tear, thus causing new wounds. 

• Place a pillow or wedge between your legs or behind your back. 
• Place a pillow or wedge under your ankles or each arm for good positioning. 
• Use a lifting sheet or lifting device to limit the rubbing against your skin. 

Proper Footwear

Wear protective and properly fitting shoes and socks to prevent foot injuries and blisters. Proper footwear is essential for preventing wound recurrence, especially for individuals with diabetes, peripheral neuropathy, or previous foot wounds. 

Seek Emotional Support

Living with chronic conditions can be emotionally challenging. Patients should seek emotional support from family, friends, or a mental health professional to help them cope with their condition. Managing the emotional aspects of chronic wound care is crucial for successful prevention. Stress, depression, and anxiety can negatively impact your immune system, sleep quality, and self-care behaviors, all of which affect your risk of wound recurrence. 

Nutrition and Diet

A good diet helps to prevent a new wound from developing. Your body will need protein and vitamins to avoid complications. Proper nutrition plays a fundamental role in maintaining healthy skin and supporting your body’s natural healing processes. Your dietary choices directly impact your immune system, circulation, and tissue integrity. 

• You need enough fluids, proteins, vitamins, and minerals. 
• .gov is a good tool to use for nutrition and dieting, as it helps you find and build your healthy eating style that fits your way of life. 
• Depending on your underlying conditions, your healthcare provider may put you on a special diet. Follow your doctor’s instructions to help prevent new wounds from occurring. 

Quit Smoking

Smoking can impair circulation and delay wound healing. Avoid smoking to reduce the risk of chronic wounds. Smoking is one of the most significant modifiable risk factors for wound recurrence. The chemicals in tobacco smoke damage blood vessels, reduce oxygen delivery to tissues, and impair your immune system’s ability to fight infection and promote healing. 

Movement and Positioning

It is important for those with immobility challenges to keep moving. Prolonged sitting or lying down can cause new wounds to form. Regular movement and proper positioning are crucial for maintaining healthy blood flow, preventing pressure buildup, and reducing your risk of wound recurrence. Even small movements can make a significant difference. 

• Turn and reposition when in bed. 
• Choose how often you turn based on any red areas on your skin. Also, consider whether you are using a special mattress or seat pad, as well as your preferences. 
• If you cannot reposition yourself, a caregiver should reposition you. If you can get out of bed, you should go from bed to chair. 
• If you can walk, you should stand and walk often. 
• When sitting in a chair, change your position every 15 minutes. 
• Keep your heels off the bed with pillows, wedges, or special footwear. 
• Only raise the head of the bed as little as possible. 
• Do not sit up too high in the bed. 

Skin Care

If you have had a chronic wound before or are at risk for developing a non-healing wound, it is important to check your skin every day with special attention to bony areas. Daily skin care is one of your most powerful tools for preventing wound recurrence. Healthy skin is your body’s first line of defense against injury and infection. 

• Wash skin with warm water and mild soap. 
• Dry all skin folds and creases. Pay special attention to the area between, under, and around the toes. 
• Protect skin from the sun to prevent skin damage. 
• Avoid cold temperatures. 
• Moisturize skin after cleansing. 
• Be sure to avoid applying lotions or creams between the toes. Only apply to the top and bottom of the foot. 

When to Seek Immediate Medical Care 

Knowing when to contact your healthcare provider can mean the difference between preventing a minor issue and dealing with a major wound recurrence 

Contact Your Healthcare Provider Immediately If You Notice: 

• Any break in the skin, regardless of size 
• Persistent redness that doesn’t improve within 24 hours 
• Swelling that doesn’t respond to elevation 
• New or worsening pain in previously healed areas 
• Signs of infection: warmth, pus, red streaking, fever 
• Changes in skin color or temperature 
• New numbness or tingling sensations 
• Any concerns about changes in your skin or overall health 

Emergency Situations Requiring Immediate Care:

• Fever with signs of skin infection 
• Rapid spreading of redness or discoloration 
• Severe pain that interferes with daily activities 
• Signs of poor circulation: cold, blue, or gray skin 
• Any wound that won’t stop bleeding 
• Signs of serious infection: confusion, rapid heartbeat, difficulty breathing 

Frequently Asked Questions 

How often should I inspect my skin? 

Daily skin inspection is recommended, preferably at the same time each day, to make it a routine. Pay special attention to areas where you’ve previously had wounds and any bony prominences. 

What should I do if I notice a small red area on my skin? 

Don’t ignore any persistent redness. Elevate the area if possible, avoid pressure on the spot, and contact your healthcare provider if the redness doesn’t improve within 24 hours or if it worsens. 

Can I prevent wound recurrence if I have diabetes? 

While diabetes increases your risk, excellent blood sugar control, proper foot care, regular medical follow-up, and adherence to prevention strategies can significantly reduce your risk of recurrence. 

How long do I need to follow these prevention strategies? 

Wound prevention is a lifelong commitment. The underlying conditions that contributed to your original wound typically remain, so ongoing prevention strategies are essential for long-term success. 

What if I can’t afford specialized equipment or products? 

Many effective prevention strategies don’t require expensive equipment. Talk to your healthcare provider about low-cost alternatives, and check if your insurance covers recommended items like diabetic shoes or pressure-relieving cushions. 

How do I know if my prevention strategies are working? 

Success is measured by maintaining healthy, intact skin over time. Regular follow-up appointments with your healthcare provider will help monitor your progress and adjust strategies as needed. 

Ready to Take Control of Your Wound Prevention? Contact Healogics today to schedule your prevention consultation. Together, we can develop a personalized plan to keep you healthy and wound-free for years to come. Click here to find a Wound Care Center® near you.