Patient Education
An open wound that refuses to close can be worrying. While many wounds close with time, others remain open even with proper care—often because something is interfering with the body’s ability to rebuild skin and seal the surface.
Healing can be happening inside even when the surface isn’t closed yet.
Problems arise when internal healing stalls and there’s no progress.
Healing is what’s happening inside the wound: new tissue forms, inflammation decreases, and the body repairs damage. Closing refers to the skin surface sealing over the wound.
A deeper wound may look open but show healthy tissue growth underneath. This can be normal— some wounds must heal from the inside out before the surface can close.
Closure may be delayed if the wound stays open without improvement—often signaling an underlying issue. Look for internal progress like healthy pink tissue, less drainage, and gradual size reduction.
Wounds usually fail to close because one or more barriers prevent new skin from forming. These barriers often overlap.
Healthy tissue is required for a wound to close. When tissue is damaged too deeply or repeatedly, closure slows. Severe tissue loss can create gaps the body struggles to bridge, and scar tissue (less flexible with reduced blood supply) can interfere with edge movement.
Infection is a common reason wounds won’t close. Bacteria trigger ongoing inflammation which prevents skin cells from migrating across the surface. Infection can also weaken wound edges, causing separation or reopening.
Some infections are subtle and not very painful—especially with nerve damage—so lack of closure plus drainage should raise concern.
Wounds heal best in a controlled, slightly moist environment. Too much moisture can damage surrounding skin, while overly dry wounds can stall healing by limiting cell movement. Dry scabs can also act as a physical barrier.
Using the appropriate dressing helps protect fragile new tissue and supports steady closure.
Some wounds need more time. Others show clear signs that closure is not progressing.
Open wounds allow bacteria easier access to deeper tissue. The longer a wound stays open, the higher the chance of infection.
Non-closing wounds may become chronic, require ongoing care, and often signal underlying health problems. Drainage, odor, and frequent dressing changes can interfere with daily life.
Open wounds may heal unevenly. Surrounding skin can break down from moisture or pressure, creating a larger problem.
In severe cases, infection can spread to deeper tissue or the bloodstream. Fever, chills, confusion, or worsening pain may indicate a medical emergency.
Daily habits still matter and can support closure alongside medical care.
Follow wound care instructions carefully and keep dressings clean.
Use dressings appropriate for the exudate level and change them as directed.
Protect fragile tissue from repeated reopening caused by movement, rubbing, or pressure.
Stay hydrated and eat enough protein and calories to support tissue repair.
Do not smoke—nicotine restricts blood flow and delays closure.
A healthcare provider should evaluate a wound that remains open after several weeks, shows signs of infection, reopens repeatedly, becomes more painful, or drains heavily. Early care often means simple adjustments (dressing changes, pressure reduction, or treating infection) rather than hospitalization.
