The wrong wound dressings can exacerbate a tunneling wound.

Some chronic wounds or wounds that take many months to heal are tunneling wounds. Tunneling wounds are among the most difficult to heal, as they often do not respond to regimes using a variety of wound dressings and need particularly treatment. Many tunneling wounds snake through the layers of tissue, creating horizontal S-shaped curved that make it difficult to aptly fill with appropriate medication. So, how do these tricky wounds develop, and what are some treatment options?

How do tunneling wounds form?

These are often secondary wounds that occur as a side effect of an infection or other issue with a primary wound. For example, tunnels can develop in pressure ulcers due to the high volume of pressure being forced upon many tissue layers, which can prompt the layers to become less voluminous than the surrounding tissues, creating a sinkhole-like effect in the skin.

Tunnel wounds can also be a side effect of improper wound assessment. If too much gauze is packed into the wound, it may create an environment that is too dry to allow the wound to heal, prompting the wound to remain concave and possibly exacerbate. Too much packing may also create more pressure within the healing wound, forcing it to extend further than its original edges.

How are tunneling wounds healed?

Most healing wounds do not respond readily to more mainstream wound care options, and clinicians are forced to create unique treatments for the wound.

Some wound treatments that do work include gels like DuoDERM Hydroactive Gel, which adjusts to treat the unique space of the wound to assist with healing. Medicated ropes that can be inserted into the wound and easily removed on a regular basis can also be a good option for the lengthy tunnel wounds.

Because the many curves of the tunneling wound are an easy place for infections to start and exacerbate, covering the wound with an antimicrobial gauze or other top dressing will help to create a more sterile healing environment.

What can a patient do during the healing process?

In addition to regularly seeking help with wound dressing changes as needed, all patients should work to keep as much pressure and/or weight off of the wound site. Most tunneling wounds are caused by excess pressure, so providing the best offloading environment possible is a must. And, of course, the patient should follow clinical instructions.