The Wound Is Closed—But Is It Healed?

Why “Invisible Wounds” should change how we define success in wound care

Let’s talk about the finish line that isn't really the finish line.

In wound care, we often celebrate closure like it’s the grand finale. The wound is closed. The chart is signed. The patient is discharged.

But what if we’ve been discharging too early? What if healing isn’t visible at all?

A recent study out of the NIDDK Diabetic Foot Consortium introduced a term that should catch the attention of every clinician, administrator, and consultant in the space: Invisible Wounds.

These are wounds that appear clinically closed but have not fully restored barrier function. In other words, they look fine. But they’re still physiologically vulnerable.

And here’s the kicker: according to the TEWL (Transepidermal Water Loss) study, this subtle lack of barrier restoration may explain why so many wounds recur despite “healing.”

Why This Matters for the Business of Wound Care

If you’re managing a wound care program-whether clinic-based, mobile, or hybrid-this isn't just a clinical issue. It’s a strategic one.

• Recurrence rates impact outcomes, cost, and credibility

• Payers are watching for long-term value, not short-term closure

• Providers need new frameworks for discharge, monitoring, and follow-up

As someone who builds systems, trains APPs, and supports operational strategy, I see this as an opportunity to evolve what we measure, how we code progress, and how we educate patients (and teams) around what “healed” really means.

So, What Can We Do Now?

• Train differently: Closure ≠ discharge. Teach APPs and providers to ask deeper questions about function, not just appearance.

• Follow longer: Post-closure protocols may need to include hydration testing, skin assessments, or even remote monitoring of re-injury risk.

• Audit smarter: Are your clinical notes reflecting true healing or surface-level improvement? That distinction may matter more than ever.

And maybe most importantly:

• Reframe our metrics. Healing isn’t an event. It’s a phase in a much longer story.

Healing Is a Milestone. Not a Destination.

“Invisible wounds” are not a buzzword. They’re a wake-up call.

They remind us that wound care is complex, that outcomes aren’t always visible, and that the true magic of healing lives beneath the surface.

Let’s build systems and standards that recognize that.

—

📌 Want to make sure your team is coding, documenting, and discharging with accuracy and strategy?📩 Email or book a call at kindlingconsulting.com and let’s talk about training, audits, or operational support.

Healing beneath the surface: understanding the hidden challenges of closed wounds.