Whether due to injury or surgery, wound healing typically progresses steadily through an orderly set of stages. Wounds that don’t heal within 1 month (30 days) are regarded as chronic. Wounds that become chronic generally stall in one or more of the phases of wound healing.
Here are 10 of the most predominant factors impacting wound healing in chronic wounds:
Age Of Patient
Healing capacity naturally declines with age. Studies depicts that individuals over 60 usually experience delayed wound healing due to physiological alterations linked with aging. Along with the presence of multiple comorbidities, there is a reduced inflammatory response, delayed angiogenesis, and slower epithelialization.
Visible skin modifications also happen with age, partly due to alterations in melanocyte function, leading to age spots, as well as decreased sebaceous gland activity, resulting in drier skin. Additionally, reduced collagen synthesis contributes to slower scar formation during the wound healing process.
Type of Wound
The features of a wound can impact the speed of wound healing. Obviously, larger wounds take longer to heal, but the shape of the wound can also play a part in the time of healing. Linear wounds usually heal faster than rectangular wounds, and circular wounds are the slowest to heal. Furthermore, wound healing is slower when wounds have necrotic tissue, desiccation, as well as foreign bodies.
Infection
All skin breaks can permit bacteria, virus, or fungus to enter the wound site. Normally, these pathogens are overtaken as well as eliminated by leucocytes/white blood cells and other components of the defence/immune system. When infection is present, up through the surface and create sore or lesion which requires treatment through superb wound care as well as perhaps administration of antibiotics.
Chronic Diseases
Patients suffering from diabetes or have diseases impacting their circulatory system may have inhibited wound healing. Efficient wound healing needs good blood flow and chronic conditions which have compromised blood flow to the wound site may require therapeutic intervention. People with chronic wounds are recommended to consult a medical professional for a comprehensive assessment to identify appropriate treatment interventions.
Poor Nutrition
In a chronically ill or geriatric patient, poor nutrition can cause the body to have insufficient resources to heal the wound. Inadequate nutrition can happen because infections increase the protein as well as caloric needs of an individual. Moreover, wounds can exude large quantities of protein on regular basis, especially in the case of large pressure ulcers (injuries) or leg ulcers. When calories are inefficient, the body may break down protein for energy, further depleting the body’s capacity to heal.
Lack of Hydration
Insufficient moisture at the wound surface can impair cellular migration, reduce oxygen delivery through the blood, as well as significantly slow the healing process. Dehydration—whether due to inadequate sodium levels or overall fluid loss—can negatively impact every stage of wound repair. While the average person may need about 64 ounces of fluids per day, individuals recovering from a wound often require increased fluid intake to bolster the movement of white blood cells to the injury site, ensuring sufficient oxygen as well as nutrient supply. Proper hydration is usually reflected by urine that is clear and nearly odourless.
Impaired Blood Circulation
Since blood delivers the necessary components to tissue for the wound healing process to take place, individuals with low blood pressure or vascular disease can have problems with delayed healing. Clogged or narrowed blood vessels or ailments of the heart, kidneys and lungs can also cause issues in the body delivering vital wound healing components, comprising white blood cells and sufficient oxygen (life saving gas), to wounded tissues.
Edema
While majority of traumatic injuries cause some tissue swelling, excessive edema can elevate the pressure on blood vessels, resulting in poorer blood circulation in the wound site/area. Tissue swelling can be caused by cardiac conditions or blood vessel issues. Compression therapy is usually effective at transporting fluids back into the circulatory system to lessen edema so proper healing can happen.
Recurring Trauma
Wounds that are repeatedly exposed to shear or sustained pressure against a surface may experience delayed healing or even complete interruption of the healing process. Such repetitive trauma is predominantly seen in bed-bound patients. It can be managed through regular repositioning schedules and the usage of appropriate offloading or protective devices, under the guidance of a healthcare/medical professional.
Patient Behaviours
Unfortunately, few patients contribute to delayed wound healing through lifestyle choices, for instance, smoking or excessive drinking. Other patient behaviours that can impact wound healing are a lack of adequate sleep, failure to elevate the affected site/area, not properly cleaning the wound, using inadequate wound dressing procedures, not keeping the wound moist and not moving enough. Listening to patients as well as offering careful education can help create better compliance with good wound healing practices.