Wounds come in various forms and can pose unique challenges when it comes to proper wound care. One such challenging wound type is tunneling wounds. Whether you are a healthcare professional or an individual seeking information about tunneling wounds, this comprehensive guide will provide you with valuable insights into this specific type of wound and how to effectively manage them.

What is a Tunneling Wound?

tunneling wound on a person’s armA tunneling wound, also known as a sinus tract, is a type of chronic wound characterized by a narrow channel or tract extending from the wound’s surface into deeper tissue. This channel or tunnel can be shallow or deep and may create pockets or dead-end passages within the wound. Tunneling wounds are commonly found in pressure ulcers, diabetic foot ulcers, surgical wounds, and wounds resulting from infections.

What Causes Tunneling in Wounds?

Several factors can lead to the formation of tunneling wounds such as:

  • Infection: Infections can erode tissue and create tunnels as the body tries to contain and eliminate the infection. Bacterial or fungal infections are common culprits.
  • Pressure: Pressure ulcers, also known as bedsores, can result in tunneling wounds when prolonged pressure on the skin disrupts blood flow and damages tissue.
  • Trauma: Wounds caused by trauma, such as surgical wounds or deep cuts, can develop tunneling if not properly treated.
  • Underlying Medical Conditions: Certain medical conditions like diabetes, vascular disease, and compromised immune systems can impede the body’s ability to heal wounds properly, increasing the risk of tunneling.
  • Foreign Bodies: The presence of foreign objects or debris within a wound can promote tunnel formation as the body tries to encapsulate and expel these materials.

Tunneling vs. Undermining Wounds

Tunneling wounds and undermining wounds are often used interchangeably, but they actually have subtle differences:

  • Tunneling Wound: As described above, a tunneling wound consists of a narrow channel or tract extending from the wound’s surface into deeper tissue.
  • Undermining Wound: Undermining, on the other hand, refers to tissue destruction beneath the wound’s surface but does not necessarily involve a tunnel extending from the wound. Undermining can lead to wound enlargement and complications if not addressed.

In practice, wound care professionals may use these terms to describe wounds with similar characteristics, and the treatment approach is often similar for both.

Risk Factors Associated with Tunneling Wounds

Several risk factors increase the likelihood of developing a tunneling wound:

  • Immobility: People who are bedridden or have limited mobility are at a higher risk of developing pressure ulcers, which can lead to tunneling wounds.
  • Diabetes: Diabetes can cause poor circulation and nerve damage, making individuals more susceptible to foot ulcers that may tunnel.
  • Obesity: Excess weight can increase the pressure on certain areas of the body, increasing the risk of pressure ulcers.
  • Aging: As individuals age, their skin becomes more fragile and less able to withstand pressure, making them more vulnerable to tunneling wounds.
  • Infection: Untreated or poorly managed infections in wounds can lead to the formation of tunnels.

Treatment and Care For Tunneling Wounds

specialist treating a tunneling foot woundIf left untreated, a tunneling wound can become deeper and even result in new tunnels developing. Additionally, it can increase the risk of further tissue being destroyed and infection spreading.

That said, specific treatment approaches for a tunneling wound may vary depending on the wound’s characteristics and underlying causes. Generally, effective tunneling wound treatment combines medical interventions and meticulous wound care practices including approaches such as:

  • Thorough Evaluation: assessment of the wound’s size, depth, location, and any associated complications, such as infection or necrotic tissue. The assessment also aids in identifying and addressing any underlying causes.
  • Removal of Necrotic Tissue: Necrotic or dead tissue within the wound must be removed through a process called debridement to create an environment conducive to healing.
  • Infection Control: Antibiotics and appropriate wound dressings may be used to manage infections and maintain sterility.
  • Wound Dressings: The use of appropriate wound dressings can help maintain a sterile environment and reduce the risk of infection.
  • Pressure Redistribution: For pressure ulcers, offloading pressure from the affected area using specialized cushions or mattresses can help improve circulation and tissue oxygenation.
  • Moist Wound Healing: Keeping the wound bed moist with appropriate dressings promotes cell migration and accelerates the healing process.
  • Wound Packing: As part of wound care, wound packing techniques are used to promote granulation tissue, absorb exudate, prevent dead space, and maintain moisture balance within tunneling wounds.
  • Topical Medications: The application of topical antimicrobial or growth-promoting agents to aid in wound healing.
  • Compression Therapy: For wounds related to vascular issues, compression therapy can improve circulation and tissue oxygenation.
  • Other Treatments: Surgical interventions, negative pressure wound therapy (NPWT), and skin grafts or flaps may be necessary for severe cases.
  • Pain Management: Adequate pain control ensures patient comfort throughout the healing process.
  • Patient Education: Educating patients on proper wound care techniques, signs of complications, and preventive measures is vital for successful healing and treatment.
  • Regular Follow-Up: Continued monitoring of the wound’s progress and adjustments to the treatment plan as needed are essential.

How Long Does it Take for a Tunneling Wound to Heal?

The time it takes for a tunneling wound to heal can vary significantly depending on several factors, including the wound’s size, depth, underlying causes, and the effectiveness of treatment. In general, tunneling wounds often take longer to heal compared to superficial wounds. Healing time can range from several weeks to several months. However, with proper wound care and treatment, most tunneling wounds should eventually heal.

Can a Tunneling Wound Heal on Its Own?

Tunneling wounds rarely heal completely on their own. These wounds are usually chronic or complex, and they often require specialized care at a wound care center and medical intervention. As we referenced earlier, left untreated, tunneling wounds are at risk of becoming infected, expanding further, and causing more severe complications.

In Conclusion

Tunneling wounds are complex and can be challenging to manage, but with proper wound care, treatment, and attention to underlying causes, they can heal successfully. Early intervention and a multidisciplinary approach involving professionals specializing in wound care can be essential to effective treatment and recovery.

If you or someone you know is dealing with a tunneling wound, the specialized team at West Coast Wound Center can help initiate an individualized treatment plan and ensure the best chance of healing and recovery. Book an appointment at our wound care center today.



2501 W Burbank Blvd #200, Burbank, CA 91505

Phone: (818) 856-9535

Fax: (818) 979-0593