# Wound that won't heal > A wound that won't heal is one that has stalled instead of steadily improving, often because of vein or artery problems, diabetes or ongoing pressure. Care depends on the cause, so finding it comes first. A wound not improving after about 4 weeks, or any foot wound with diabetes, should be checked. Guide in [Diabetes and your feet](https://footanklelowerlimb.com.au/learn/topics/diabetes-and-your-feet), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/wound-not-healing Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026. Next review by 27 October 2027. - **It's a wound that has stalled,** not moving through the usual stages of healing in a timely way. - **The cause matters:** vein or artery problems, diabetes and pressure are common reasons, and each needs different care. - **Circulation is checked first:** compression helps many leg ulcers, but isn't suitable if the arteries are affected. - **Getting it looked at early helps:** a wound that hasn't improved after about 4 weeks needs reassessing. - **Ulcers can come back,** so care after healing matters. ## What is a wound that won't heal, and how common is it? A wound that won't heal (a chronic or hard-to-heal wound) doesn't move through the normal stages of healing in a timely way, and often gets stuck in the swelling (inflammatory) stage [1]. Several things usually overlap, such as an underlying illness, poor nutrition and pressure on the area [1]. There's no single agreed cut-off for when a wound counts as stalled. One guide is a wound that hasn't healed or shrunk by about 40–50% within 4 weeks [2]. A leg ulcer (an open sore between the knee and ankle) is long-lasting when it takes more than 2 weeks to heal [3]. These wounds are common in some groups. Venous leg ulcers often affect older adults and can last a long time [4], and as many as 34% of people with diabetes develop an ulcer on the sole of the foot over their lifetime [5]. ## What can cause a wound not to heal? Most leg ulcers come from vein problems. About 80% are venous ulcers, about 15% are arterial (from poor blood flow in the arteries), and about 5% have other causes, such as injury, inflammatory conditions or a skin tumour [6][3]. Venous ulcers usually develop on the inside of the leg between the knee and ankle [3]. In people with diabetes, long-term high blood sugar can damage nerves and blood vessels and keep inflammation going, which slows healing of foot ulcers [7]. Ongoing pressure on one area can also stop a wound healing [1]. ## How is the cause found? A podiatrist or doctor looks at the whole person, not just the wound. They ask about your health history and examine your legs and the wound for signs of vein disease, artery disease or other causes [6]. Your circulation is checked too, usually with a Doppler ABPI (a test that compares blood pressure at your ankle and arm using a small ultrasound probe), before any compression [6]. Feeling foot pulses alone can't reliably rule out poor circulation in people with diabetes [8]. Automated devices can underestimate artery disease in people with leg ulcers [9], and a reading can look falsely normal in people with diabetes or kidney disease because of stiff, calcified arteries [10]. So results are read alongside the examination [6]. For a new diabetic foot ulcer, a probe-to-bone test (a gentle check with a thin probe for whether the wound reaches bone) and X-rays are recommended, with an MRI scan if a deep infection or abscess is suspected [11]. ## What helps first? Treatment depends on the cause. - **Venous leg ulcers:** compression (firm bandages or stockings that support the veins) is the first treatment [12][6]. It's used only after circulation is checked, because compression isn't suitable if you have peripheral artery disease (narrowed leg arteries) [9]. - **Diabetic foot ulcers:** care usually combines taking pressure off the area, blood sugar control, treating infection, removing dead tissue and modern dressings [7]. - **Advanced arterial ulcers:** restoring blood flow with a procedure or surgery is the first treatment, aiming to reduce pain and save the leg [12]. Eating enough calories, protein, vitamins A and C and zinc supports healing, and unmet energy and protein needs can delay it [1]. > [!tip] Try this > Write down the date the wound started and note its size, or take a photo. At your first visit, this helps you and your podiatrist see by about week 4 whether it's shrinking. ## What helps if that isn't enough? If a wound hasn't healed or shrunk by about 40–50% after 4 weeks, referral to a qualified wound care provider for a closer look is advised [2]. It's worth checking whether infection, pressure, poor circulation, nutrition or blood sugar is holding healing back. If poor blood flow is the problem, a procedure to restore it may be needed rather than more local treatment [12]. For diabetic foot ulcers, extra options such as negative pressure wound therapy (a dressing that applies gentle suction) and hyperbaric oxygen therapy (breathing oxygen in a pressurised chamber) aren't cure-alls. They belong within a team plan that includes blood sugar control, infection care and taking pressure off the foot [13]. ## Will it heal, and how can I stop it coming back? Outlook depends on the type of wound, and ulcers often come back. After a diabetic foot ulcer closes, the risk of a new one is highest straight away: 40% have another within 12 months, and nearly 60% within 3 years [5]. It helps to arrange close early follow-up, check your feet regularly and report any new sore early. After a venous leg ulcer heals, compression stockings are a safe and effective way to help stop it returning [4]. Circulation should still be checked first, and poor blood flow to the limb or fluid in the lungs means compression isn't suitable [4][9]. ## When to see a podiatrist Call 000 and ask for an ambulance if a leg or foot suddenly turns cold and pale or blue, with pain or numbness, or you can't move it. Go to the nearest emergency department if you have diabetes and a foot infection that's spreading fast, with a fever, and you feel very unwell. See your GP or a podiatrist the same day if: - you have diabetes and a cut, blister, bruise or sore on your foot that hasn't started to heal after a few days, or the skin turns red, warm or painful [14]; - you have diabetes and a toe or foot that's red, hot and swollen [15]; - any wound has more swelling, redness, pain or heat, more or changed discharge (such as thick and yellow), a bad smell, or you have a fever or feel unwell [16][1]; - an infected foot is turning black and smelly, which may be gangrene [14]. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic. Treating a foot infection quickly matters, because an infected foot ulcer raises the risk of amputation [17]. See a podiatrist or your GP if a wound hasn't improved after about 4 weeks, so it can be reassessed and a wound clinic considered [18]. See your GP soon if a sore is extremely painful for its size, is growing quickly, or doesn't fit the usual patterns [12]. ## Common questions ### Is a wound that won't heal an infection? Not always. A wound can stall for several reasons, including poor circulation, ongoing pressure, poor nutrition and diabetes, and infection is only one of them. Because infection can also be present, it's worth having any wound that isn't improving looked at, so the cause can be found and treated. ### Can I treat a corn or a wound on my foot myself if I have diabetes? It's best not to manage it on your own. If you have diabetes, a foot wound, blister, corn or sore should be looked at by your GP or a podiatrist, because any delay in getting advice can lead to serious problems. They can tell you what's safe to do at home while it heals. ## Further reading - [Wound that won't heal on Clindice](https://clindice.com/wound-not-healing) - [Diabetic Foot Exam: MedlinePlus Medical Test](https://medlineplus.gov/lab-tests/diabetic-foot-exam/), MedlinePlus - [Leg Ulcers: What Is It, Treatments, Causes and Types](https://my.clevelandclinic.org/health/diseases/23329-leg-ulcers), Cleveland Clinic - [Leg ulcers — foot ulcers](https://www.healthdirect.gov.au/conditions/skin-conditions/leg-ulcers), healthdirect - [Wound healing and wound dressings](https://www.enherts-tr.nhs.uk/wp-content/uploads/2025/04/Wound-healing-and-wound-dressings-V1.1-05.2025.pdf), NHS ## Sources 1. Wound healing and wound dressings · NHS. https://www.enherts-tr.nhs.uk/wp-content/uploads/2025/04/Wound-healing-and-wound-dressings-V1.1-05.2025.pdf 2. The role community-based healthcare providers play in managing hard-to-heal wounds · Beeckman D, Cooper M, Greenstein E et al. · International Wound Journal · 2024. https://doi.org/10.1111/iwj.14402 3. Venous leg ulcer · NHS. https://www.nhs.uk/conditions/leg-ulcer/ 4. Compression Stockings for the Prevention of Venous Leg Ulcer Recurrence: A Health Technology Assessment · Ontario Health Technology Assessment Series · 2019. https://pmc.ncbi.nlm.nih.gov/articles/PMC6394515/ 5. Diabetic Foot Ulcer Beyond Wound Closure: Clinical Practice Guideline · Wendland DM, Altenburger EA, Swen SB et al. · Physical Therapy · 2025. https://doi.org/10.1093/ptj/pzae171 6. Assessment and management of leg ulcers including ankle brachial pressure index (ABPI) (G126) · NHS. https://www.rightdecisions.scot.nhs.uk/nhs-ayrshire-arran-guidelines/clinical-guidelines/patient-care/assessment-and-management-of-leg-ulcers-including-ankle-brachial-pressure-index-abpi-g126/ 7. Epidemiology, pathophysiology, and management of diabetic foot: A comprehensive review · Pavithra TR, Kaliyaperumal R · Foot (Edinburgh, Scotland) · 2026. https://doi.org/10.1016/j.foot.2026.102225 8. Effectiveness of bedside investigations to diagnose peripheral artery disease among people with diabetes mellitus: A systematic review · Forsythe RO, Apelqvist J, Boyko EJ et al. · Diabetes/metabolism Research and Reviews · 2020. https://doi.org/10.1002/dmrr.3277 9. Automated devices for identifying peripheral arterial disease in people with leg ulceration: an evidence synthesis and cost-effectiveness analysis · Boyers D, Cruickshank M, Aucott L et al. · Health Technology Assessment (Winchester, England) · 2024. https://doi.org/10.3310/twcg3912 10. Pedal acceleration time as a diagnostic and prognostic tool in peripheral artery disease: systematic review and meta-analysis · Rosado-Fonseca M, Silva E, Ribeiro T et al. · BMC Medical Imaging · 2026. https://doi.org/10.1186/s12880-026-02493-y 11. The management of diabetic foot: A clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine · Hingorani A, LaMuraglia GM, Henke P et al. · Journal of Vascular Surgery · 2016. https://doi.org/10.1016/j.jvs.2015.10.003 12. Consensus on the diagnosis and management of chronic leg ulcers - Brazilian Society of Dermatology · Abbade LPF, Frade MAC, Pegas JRP et al. · Anais Brasileiros de Dermatologia · 2020. https://doi.org/10.1016/j.abd.2020.06.002 13. Comparative Evidence on Negative Pressure Therapy and Hyperbaric Oxygen Therapy for Diabetic Foot Ulcers: A Systematic Review of Independent Effectiveness and Clinical Applicability · Astasio-Picado Á, Jurado-Palomo J, Pozo-Aranda B et al. · Medicina (Kaunas, Lithuania) · 2026. https://doi.org/10.3390/medicina62010109 14. Diabetes & Foot Problems · National Institute of Diabetes and Digestive and Kidney Diseases · 2026. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems 15. Looking after your foot in remission · Information Site. https://mydiabetesmyway.scot.nhs.uk/resources/internal/looking-after-your-foot-in-remission/ 16. Understanding your Chronic Wound · NHS. https://www.rightdecisions.scot.nhs.uk/media/uvlpxwrw/20180119-awd-pil-understanding-your-chronic-wound-a5-1.pdf 17. Looking after your diabetic foot ulcer to reduce the risk of amputation · Information Site · 2025. https://mydiabetesmyway.scot.nhs.uk/resources/internal/looking-after-your-diabetic-foot-ulcer-to-reduce-the-risk-of-amputation/ 18. An update on wound management · Sussman G · Australian Prescriber · 2023. https://doi.org/10.18773/austprescr.2023.006 --- This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.