There are several reasons a person may develop an open wound. Common wound types are burns, animal bites, diabetic ulcers, venous ulcers, arterial ulcers and pressure ulcers.


Diabetic wounds are generally on the bottom of the foot and result from peripheral neuropathy (poor sensation), trauma, prolonged pressure, poor foot care and poor foot wear. Sometimes people can’t feel when they’ve stepped on a sharp object or if their shoe is rubbing when they have poor sensation and this can create a wound. It is important for people with diabetes and poor sensation to look at their feet every day to check for any changes in their skin.


Venous ulcers are usually on the lower leg and ankle. People usually have swelling in their leg and these wounds have a lot of drainage. Signs of venous disease are varicose veins (veins that bulge out), spider veins, heaviness and/or achiness in the legs at the end of the day.


Arterial ulcers are often seen on the legs around bony areas and the toes. They have a cookie cutter, punched out appearance. People with arterial disease may also have leg cramps, pain with walking and when the legs are elevated. It can feel better to have your legs down if you have arterial disease as gravity is helping your blood get to your feet.


Pressure ulcers are located over bony surfaces such as heels, tailbone, elbows, etc. They are caused by prolonged pressure and are usually due to impaired mobility. The best way to prevent them is to keep clean and dry, change positions frequently and use pillows or cushions to off-weight those bony prominences.


Some factors that can negatively affect healing are:

  • Smoking
  • poor nutrition
  • stress
  • trauma
  • infection
  • prolonged illness and not being able to move


Who can help you with these wounds? A Physical Therapist (PT) can!


Many Physical therapists (PTs) have been trained in wound care. When the PT sees you for the first time, they will look at the wound size, tissue type, drainage amount, and surrounding skin. Based on what they see, the PT will develop a treatment plan which will include cleaning the wound, choosing a dressing or bandage, and maybe removing dead tissue from the wound if it needs it. Depending on the wound and the amount of care needed, the patient may need physical therapy anywhere from once a week to daily.

The PT hopes to educate the patient, decrease the risk of infection, and ultimately heal the wound.

North Country Hospital has two Physical Therapists who are Certified Wound Specialists to help you with your wound care needs. North Country Hospital’s PT clinic has non-contact low frequency ultrasound, low level laser, and electrical stimulation modalities to further accelerate wound healing.


If you have a wound that is not healing, see your doctor and request a PT consult.


Submitted by: Sarah Hardin, PT, CWS is a Physical Therapist and Certified Wound Specialist at North Country Hospital. She has been a physical therapist for over 17 years and has been treating wounds for 16 years.