Wound Not Healing: When to Call a Home Health Nurse

3 days ago

9 min read

Disclaimer: This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always talk with your doctor or a qualified health provider about your own health.

home health nurse bandaging an older patient’s lower leg in a bright living room

A wound not healing is usually telling you something: pressure, poor blood flow, or infection. The fix is rarely another week of the same dressing.

Most minor wounds close within a few weeks. If yours is no smaller after two weeks of steady care, or if it looks worse, that is the moment to have someone trained to look at it. Waiting longer rarely helps, and it gives infection time to settle in.

How Long Should a Wound Take to Heal?

A simple wound moves through clear stages, and most of the visible work is finished in about three weeks.

After the bleeding stops, the body spends roughly two to five days on inflammation. The area looks swollen, pink and tender, and clear fluid may drain from it. That stage is the immune system doing its job, not a sign that something has gone wrong.

New tissue then fills the gap. According to MedlinePlus (2026), that rebuilding happens over the next three weeks or so, with the edges pulling inward as the wound shrinks. Scars keep changing for much longer, sometimes as long as two years.

Size matters here. Small, shallow wounds close faster, and large or deep ones take longer and are more likely to scar. So the useful question is not how many days have passed. It is whether the wound is smaller this week than it was last week.

What Counts as a Wound Not Healing After 2 Weeks?

There is no single cut-off, but a wound that shows no progress over several weeks is treated as a different problem from a fresh cut.

Clinical references draw the line in different places. The StatPearls wound assessment chapter (2023), hosted by the National Library of Medicine, describes chronic wounds as those lasting longer than six weeks, and notes that some clinicians use three months without progress instead.

Two weeks is still a sensible personal deadline. If the wound is the same size, the same depth and the same colour it was fourteen days ago, something is holding it back. Finding out what, early, is far easier than treating a wound that has been open for two months.

This is common rather than rare. A study of Medicare claims published in the Journal of Medical Economics (2023) found that 10.5 million Medicare beneficiaries had a wound in 2019, up from 8.2 million five years earlier.

Wounds That Need Watching Sooner

Some wounds deserve attention well before the two-week mark. A wound on a foot or lower leg in someone with diabetes, a sore over a hip or tailbone in someone who spends most of the day in bed, and any wound in someone with poor circulation all belong in that group.

In those cases the skin has less margin. Reduced feeling means an injury can go unnoticed for days, and reduced blood flow means the repair work runs slowly from the start. A small break in the skin can become a deep one in days rather than weeks.

How Do You Spot Infection in a Wound?

Infection usually shows up as more redness, more pain and changed drainage, after the wound had already started to settle.

The pattern matters more than any single sign. A wound that was improving and then turns redder, warmer or more painful has changed direction. Drainage that becomes yellow, green, cloudy or foul smelling points the same way, and so does a fever.

The CDC (2024) lists redness and pain near the site, cloudy fluid draining from the wound and fever as typical signs of a surgical site infection, and says to contact a provider immediately when they appear.

A few other changes are worth a same-day call. Black edges around the wound can mean dead tissue. Bleeding that will not stop after ten minutes of firm pressure needs attention. So does a wound that reopens after it has closed.

Skin Not Healing After Surgery: What Should You Do?

An incision that is left open is usually left open on purpose, and it needs a different kind of care than a stitched one.

A surgical wound that is not closed heals from the inside out. The dressing is there to absorb drainage and to keep the skin surface from sealing over before the tissue underneath has filled in. Packing it correctly is the whole point, and it is easy to get wrong.

How to Change the Dressing Safely

Hand washing comes first, for fifteen to thirty seconds, every single time. The old dressing is removed gently, and wetted first if it sticks. The skin around the wound is cleaned with saline or mild soapy water, and a new dressing is used at every change.

What to Keep Away From the Wound

What to leave out matters just as much. Alcohol, peroxide, iodine and antibacterial soaps can slow healing rather than help it. Lotions, creams and herbal remedies should wait until a provider approves them.

The incision is rarely the only thing going on after an operation. Recovering at home after surgery usually means a nursing team handles the dressing changes alongside mobility, nutrition and the rest of the plan.

Why Is a Leg Wound or Foot Wound Not Healing?

Lower-leg and foot wounds stall more often than wounds anywhere else, almost always because of blood flow, pressure or diabetes.

Blood carries the oxygen and the cells that rebuild tissue. When arteries are narrowed or veins are not emptying properly, that delivery slows and the wound sits still. Swelling adds to the problem, because fluid under the skin keeps the wound edges apart.

Diabetes complicates both halves. It raises the risk of a wound turning chronic, and nerve changes can mean a blister or a pebble in a shoe goes unnoticed until the skin has broken down underneath.

Other things slow healing too: smoking, heavy alcohol use, older age, carrying extra weight, and some long-term medicines. None of these make healing impossible. They do mean the wound needs a plan rather than patience.

Treating Bedsores at Home: What Actually Helps

Pressure sores heal when the pressure comes off. Everything else is secondary.

A pressure sore forms where skin is pressed against a bed or a chair long enough to cut off blood flow. Heels, ankles, hips, the tailbone, elbows, shoulder blades and the back of the head are the usual places, and the first sign is often a patch of skin that stays red.

Taking the Pressure Off

Repositioning is the treatment. MedlinePlus (2026) advises shifting position about every fifteen minutes in a wheelchair and every two hours in bed, using foam or gel cushions and pads to spread the load.

Two common habits do harm. Massaging a reddened area damages fragile tissue underneath, and donut-shaped cushions concentrate pressure in a ring instead of spreading it. Keeping sheets smooth and dry helps more than either of them.

Caring for the Sore Itself

Keep it clean, cover it with the dressing your provider recommended, and check the skin every day. Stage one and stage two sores are often managed at home. Deeper ones, where the wound reaches fat, muscle or bone, usually need a wound specialist involved.

Nutrition is part of the treatment rather than an extra. Skin rebuilds out of protein, calories and fluid, and someone who has been eating poorly for a month will heal slowly whatever dressing goes on top.

Call a provider for pus, a foul smell, spreading redness or warmth, swelling, fever, or any new blister or open sore.

When Does a Wound Need a Wound Care Nurse?

When the dressing change itself takes skill, or when the wound has stopped responding to what you are doing at home.

Some tasks are nursing work by definition: sterile dressing changes, packing a deep or tunnelled wound, removing sutures or staples, managing drains, and judging whether tissue is healthy or dying. Those are not things to learn from a video at the kitchen table.

A nurse also brings a measuring habit. Wounds get tracked by length, width, depth and the look of the tissue, visit after visit, so the question of whether it is improving gets an answer instead of an opinion.

That is the work a certified agency does inside the house. 911 AM PM Home Health Care sends skilled nurses to patients across Los Angeles, Ventura, Orange, Riverside and San Bernardino counties, with wound care handled as part of the nursing plan of care.

Families often notice the need before the wound does: more help with washing, more days in the chair, a parent who stops mentioning the sore. Those are among the usual signs that an older parent needs home health care, and they count as much as the measurements.

The split between home care and skilled care is clearer than it looks. This is roughly where the line falls:

Situation	Who Usually Handles It
Minor cut or scrape with clean edges	Family at home: wash, cover, watch for infection
Dressing change on a closed, healing incision	Family at home, following discharge instructions
Stage 1 or stage 2 pressure sore	Family at home with pressure relief, reviewed by a provider
Packing a deep or tunnelled wound	Skilled nurse
Sutures, staples or a drain to remove	Skilled nurse
Pus, spreading redness, foul smell or fever	Provider the same day, then skilled nursing if ordered
Stage 3 or stage 4 pressure sore	Wound specialist together with skilled nursing

The row that matters most is the last one. A sore that reaches fat, muscle or bone has moved past home management, and the sooner a specialist sees it, the fewer months the whole thing takes.

How Do You Get a Wound Care Consult and Home Health?

A doctor has to order it, and the patient has to meet two conditions.

Getting the Doctor's Order

The order comes first. A doctor or other provider sees the patient in person, confirms that home health is needed, and orders it. A Medicare-certified agency then takes the referral, assesses the wound and opens a plan of care.

Two conditions decide coverage. The patient needs part-time or intermittent skilled care, and the patient has to be homebound. What homebound actually means is narrower than most families expect, though it still allows medical visits and short outings.

How Often a Nurse Will Come

Visit frequency follows the wound, not the family's preference. A wound that needs daily packing looks nothing like one that needs a check twice a week, and how often the home health team visits is set by that clinical need and reviewed as the wound changes.

If you are unsure whether the situation qualifies at all, the test is narrower than age or diagnosis. Who qualifies for home care turns on the skilled need and the homebound rule, so it is worth asking rather than assuming.

The Bottom Line on a Wound That Will Not Heal

Progress is the measure, not time.

A wound that is smaller and cleaner each week is healing, even slowly. A wound that looks the same after two weeks, or that turns redder, more painful or smellier, has stopped healing and needs a different plan rather than a repeat of the old one.

The things that stall wounds are all treatable once someone works out which one is at work: pressure, poor circulation, diabetes, infection, poor nutrition. That assessment is the part worth asking for early, while the wound is still small.

Ask About In-Home Wound Care

Frequently Asked Questions

Can I shower with an open wound?

Ask your provider first, because the answer depends on the dressing and the wound. Many dressings are meant to stay dry, while others are water resistant. Your nurse can show you how to cover it and what to do if it gets wet anyway.

Does a wound heal faster, covered or uncovered?

Covered, in most cases. A dressing keeps the surface from drying out and protects new tissue from friction and dirt. The exception is a wound your provider has specifically told you to leave open to the air.

Is itching a sign that a wound is healing or infected?

Itching is common while a scar forms and is usually part of normal repair. Infection tends to bring pain, warmth and changed drainage rather than itch on its own. New pain after a quiet stretch is the signal worth calling about.

What is debridement, and will it hurt?

Debridement means removing dead tissue so healthy tissue has room to grow. There are several ways to do it, and the clinician chooses based on the wound. Discomfort varies, and your provider should explain how it will be managed before anything starts.

Can a wound care nurse come if the patient is not on Medicare?

Yes. Agencies also work with Medicare Advantage plans, private insurance and private pay, although the approval steps and paperwork differ. Ask the agency which applies to your situation before care begins.

How long does home health wound care usually last?

Until the wound closes or the skilled need ends. Some wounds take a few weeks and others several months. The plan is reviewed at set intervals, and the agency should tell you where things stand at each review.