From the Guidelines
For a wound on the shin that is not healing, you should seek medical attention as soon as possible, as the most recent and highest quality study suggests that early intervention is crucial in preventing complications and promoting healing 1. Non-healing wounds on the lower leg often require professional evaluation because they may indicate underlying issues such as poor circulation, diabetes, or infection. In the meantime, keep the wound clean by gently washing with mild soap and water daily, then apply an antibiotic ointment like Neosporin or Polysporin and cover with a sterile non-stick dressing such as Telfa. Change the dressing daily or whenever it becomes wet or soiled. Elevate your leg when sitting or lying down to reduce swelling and improve circulation. Avoid putting pressure on the wound and don't pick at any scabs that form. Shin wounds often heal slowly because the area has relatively thin skin, less blood supply, and is frequently subjected to movement and pressure. If you notice increasing redness, warmth, swelling, pus, foul odor, or if you develop fever, these could indicate infection requiring immediate medical attention. People with diabetes, peripheral vascular disease, or compromised immune systems should be especially vigilant about wound care and should not delay seeking professional help.
Some key considerations for wound care include:
- Providing optimal wound care, in addition to appropriate antibiotic treatment of the infection, is crucial for healing 1
- The use of autologous leucocyte/platelet/fibrin patch, topical oxygen therapy, and hyperbaric oxygen therapy may be considered in certain cases 1
- Sharp debridement and the selection of dressings are important aspects of wound care 1
- Surgical consultation and intervention may be necessary for infections accompanied by a deep abscess, extensive bone or joint involvement, crepitus, substantial necrosis or gangrene, or necrotizing fasciitis 1
It is essential to note that the treatment of non-healing wounds requires a comprehensive approach, taking into account the underlying cause of the wound, the presence of any underlying medical conditions, and the need for ongoing wound care and monitoring. The most recent study suggests that the use of sucrose-octasulfate impregnated dressings and autologous combined leucocyte, platelet and fibrin patch may be considered in difficult to heal neuro-ischaemic ulcers, in addition to best standard of care 1. However, it is crucial to consult with a healthcare professional to determine the best course of treatment for a specific wound.
From the Research
Treatment of Non-Healing Wounds on the Shin
- Non-healing wounds, including those on the shin, represent a challenging problem for physicians and patients alike 2.
- A multidisciplinary approach and individualized plans of care are key points in managing lower extremity wounds, including those on the shin 2.
- Chronic wounds, defined as those that have failed to heal after three months, can be caused by various intrinsic and extrinsic factors, including comorbidities and lifestyle factors 3.
Management Principles
- A comprehensive treatment plan is essential for faster healing and improved outcomes 2.
- Assessment and treatment of non-healing chronic wounds should include advanced interventions such as electrical stimulation therapy, negative pressure wound therapy, and various dressings 3.
- Antimicrobial dressings have emerged as a promising approach for bioburden control and wound healing, and their selection depends on various parameters, including cost, wound type, and local microbial burden 4.
Current Management Guidelines
- Preventative and treatment measures for chronic wounds include disease-specific approaches and the use of moisture retentive dressings and adjunctive topical therapies to promote healing 5.
- A consensus on the best treatment of chronic wounds emphasizes the need for simplified wound care that can be delivered by the patient or their family, as well as the importance of telemonitoring and defining patient expectations 6.
- Patient outcomes may include wound-specific outcomes, such as time to heal and wound size reduction, as well as improvement in quality of life 6.