Wound Conditions We Treat: A Complete Guide to Chronic Wound Types

Not all wounds are the same — and not all wounds heal the same way. Chronic wounds, in particular, often stall because the underlying cause hasn't been fully addressed. At Mend Wound Solutions, our certified wound care specialists identify not just what the wound looks like, but why it isn't healing — and build a treatment plan around that answer.

Below is a guide to the most common wound types we treat, including what causes them, how to recognize them, and what effective treatment looks like.

Diabetic Foot Ulcers (DFU)

What They Are

Diabetic foot ulcers are open sores or wounds that develop on the feet or lower legs of people with diabetes. They affect up to 25% of people with diabetes over their lifetime and are the leading cause of non-traumatic lower extremity amputation in the United States. Despite this, they are highly treatable when caught and managed appropriately.

What Causes Them

Diabetes damages both blood vessels and nerves over time. Nerve damage (neuropathy) reduces sensation in the feet, meaning small injuries — a blister, a cut, pressure from a shoe — go unnoticed. Poor circulation means those injuries don't receive adequate blood flow to heal. The combination of undetected injury and impaired healing is what allows a small wound to become a serious ulcer.

Signs to Watch For

Seek specialist wound care if you or a loved one has:

• Any open wound on the foot or lower leg in a person with diabetes

• A wound that has been present for more than 4 weeks

• Redness, warmth, swelling, drainage, or odor from a foot wound

• Reduced or absent sensation in the feet

• A wound that is getting larger or deeper despite treatment

• Any history of prior foot or toe amputation

How We Treat It

Treatment at Mend begins with a comprehensive assessment including wound measurement, tissue evaluation, infection screening, vascular status review, and offloading analysis. We use advanced debridement, bioengineered skin substitutes (covered under Traditional Medicare), appropriate wound dressings, and close coordination with the patient's primary care provider and any vascular or podiatric specialists involved in their care.

Venous Leg Ulcers (VLU)

What They Are

Venous leg ulcers are the most common type of lower extremity wound, accounting for up to 70% of all leg ulcers. They develop on the lower leg, typically near the ankle, and are caused by chronic venous insufficiency — a condition in which the veins of the legs fail to return blood efficiently to the heart.

What Causes Them

When venous valves are damaged or weakened, blood pools in the lower legs. This pooling increases pressure in the veins, causing fluid to leak into surrounding tissue. Over time, the skin and tissue break down, leading to ulceration. Without addressing the underlying venous pressure, these wounds frequently recur even after healing.

Signs to Watch For

• A shallow, irregularly shaped wound on the lower leg or ankle

• Surrounding skin that is discolored (reddish-brown or purple), thickened, or itchy

• Significant leg swelling, particularly toward the end of the day

• A wound that has been present for months or years without fully healing

• A history of prior leg ulcers

• Heavy, aching legs or visible varicose veins

How We Treat It

Compression therapy is the cornerstone of venous ulcer management — it reduces the venous pressure that drives wound formation and is the single most effective intervention for healing and preventing recurrence. At Mend, we apply evidence-based multi-layer compression alongside moisture-balanced wound dressings, patient and caregiver education on compression compliance, and vascular specialist coordination when indicated.

Pressure Injuries (Pressure Ulcers / Bedsores)

What They Are

Pressure injuries — also called pressure ulcers or bedsores — develop when sustained pressure on the skin reduces blood flow to the tissue beneath it. They range in severity from Stage I (intact skin with non-blanchable redness) to Stage IV (full-thickness tissue loss exposing bone, tendon, or muscle). Unstageable wounds and deep tissue pressure injuries are also recognized clinical presentations.

What Causes Them

Pressure injuries develop when tissue is compressed between a bony prominence and an external surface for a sustained period. Contributing factors include shear forces (skin moving in one direction while underlying tissue moves in another), moisture from incontinence or perspiration, malnutrition, reduced mobility, diabetes, and vascular disease. Common locations include the sacrum, heels, hips, and ankles.

Who Is Most at Risk

• Patients who are bed-bound or wheelchair-dependent

• Residents of skilled nursing facilities or long-term care communities

• Patients recovering from surgery or prolonged hospitalization

• Individuals with diabetes, peripheral vascular disease, or malnutrition

• People with incontinence or reduced skin integrity

How We Treat It

Mend provides bedside pressure injury management in skilled nursing facilities, assisted living communities, and private homes across Colorado Springs and the Front Range. Our certified specialists perform sharp debridement, apply advanced wound therapies including negative pressure wound therapy and bioengineered skin substitutes, and work alongside facility nursing staff to address the repositioning, nutrition, and moisture management factors that drive wound progression.

Arterial Ulcers (Ischemic Wounds)

What They Are

Arterial ulcers develop when insufficient arterial blood flow deprives tissue of oxygen and nutrients. Unlike venous ulcers, which result from blood pooling in the veins, arterial ulcers are caused by peripheral arterial disease (PAD) — a narrowing of the arteries that reduces blood supply to the lower extremities.

Signs to Watch For

• Wounds on the toes, feet, or lower leg that appear punched out with well-defined edges

• Pale, shiny, or hairless skin around the wound

• Pain in the legs when walking (claudication) or at rest

• Cold feet or toes compared to the rest of the leg

• Absent or diminished pulses in the foot

• Wounds that produce minimal drainage

How We Treat It

Arterial ulcers require vascular evaluation as a priority — without adequate blood flow, no wound care intervention can achieve healing. Mend coordinates closely with vascular surgery for patients with suspected arterial or mixed etiology wounds. We assess ankle-brachial index (ABI), manage the wound environment to prevent deterioration, and ensure the patient is connected to vascular specialty care in a timely manner.

Post-Surgical and Traumatic Nonhealing Wounds

What They Are

Some wounds fail to heal following surgery or injury despite appropriate initial care. Surgical wound dehiscence (separation of wound edges), post-operative infections, and traumatic wounds that exceed the body's natural healing capacity all fall into this category. These wounds are particularly common following orthopedic, abdominal, cardiovascular, and reconstructive procedures.

Why They Stall

Post-surgical wounds may fail to heal due to infection or biofilm, poor vascular supply to the surgical site, patient factors such as diabetes, malnutrition, or immunosuppression, mechanical stress on the wound closure, or retained foreign material. Identifying which factor — or combination of factors — is driving the stall is essential to choosing the right intervention.

How We Treat It

Mend works in close coordination with the operating surgeon and the patient's care team to manage post-operative wound complications. Our approach includes debridement of nonviable tissue, infection management, negative pressure wound therapy, and — where appropriate — bioengineered skin substitutes to accelerate closure. We communicate proactively with surgical teams throughout the episode of care.

Infected Wounds and Wound Biofilm

What They Are

All chronic wounds carry bacteria, but not all wounds are infected. Infection becomes clinically significant when bacteria overwhelm the wound's local defenses and trigger a host response. A more subtle but equally important problem is biofilm — a structured community of bacteria that forms a protective matrix on the wound surface, making it highly resistant to antibiotics and the body's immune response.

Signs of Wound Infection

• Increasing pain in a wound that was previously comfortable

• Redness or warmth extending more than 2cm from the wound edge

• Purulent (pus-like) drainage or foul odor

• Wound that was improving but has suddenly stalled or worsened

• Fever, chills, or confusion (signs of systemic infection — seek urgent care)

How We Treat It

Mend's approach to infected wounds and biofilm includes sharp debridement to disrupt the biofilm matrix, topical antimicrobials (silver, iodine-based, or DACC dressings), wound cultures to guide antibiotic selection when systemic infection is present, and close monitoring for escalation. We do not rely on antibiotics alone for biofilm-related stalls — mechanical disruption through debridement is essential.

Frequently Asked Questions About Chronic Wounds

How do I know if my wound is chronic?

A wound is generally considered chronic if it has not shown meaningful progress toward healing within 4 weeks of appropriate treatment. Signs that your wound may need specialist attention include: it is getting larger or deeper rather than smaller, it has been present for more than a month, it is draining, painful, or has an odor, or it has stopped responding to the wound care you've been doing.

Do I need a referral to be seen at Mend Wound Solutions?

No. You can contact us directly by calling 719-922-1002 or emailing office@mendmywound.com. We will verify your insurance and schedule your initial evaluation. If you have a primary care provider or specialist involved in your care, we will coordinate with them — but you do not need a referral to reach us.

Does Medicare cover wound care?

Yes. Mend Wound Solutions accepts Traditional Medicare (Parts A & B) as primary insurance. Medicare covers a wide range of wound care services including evaluation and management visits, debridement, negative pressure wound therapy, and — in appropriate clinical situations — bioengineered skin substitutes and amniotic membrane allografts. We verify your specific coverage before your first visit.

Can you come to me?

Yes. In addition to our clinic at 595 Chapel Hills Drive in Colorado Springs, our team provides mobile wound care to patients in their homes, skilled nursing facilities, assisted living communities, and acute rehab hospitals across Colorado Springs, Pueblo, and the broader Front Range. If you are not able to travel to our clinic, we can come to you.

What is the hardest type of wound to heal?

Wounds with multiple compounding factors are the most challenging — for example, a diabetic foot ulcer with arterial disease and active infection, or a Stage IV pressure injury in a malnourished patient with limited mobility. These cases require coordinated, multidisciplinary care that addresses not just the wound surface but every systemic factor working against healing. This is exactly the type of patient Mend was built to treat.

Ready to get started? Call us at 719-922-1002, fax to 719-888-1841, or email office@mendmywound.com. No referral required.