There are several factors that affect wound healing and contribute to the pathogenesis of
A skin wound that doesn't heal, heals slowly or heals but tends to recur is known as a chronic wound. Some of the many causes of chronic (ongoing) skin wounds can include trauma, burns, skin cancers, infection or underlying medical conditions such as diabetes.
Vitamin C deficiency has been found to impair wound healing and has also been associated with an increased risk of wound infection.
Chronic illness
Diabetes can slow the healing process by making white blood cells less effective. Diabetes, cardiovascular disease, and other conditions that give rise to poor circulation may also make it harder for your body to deliver oxygen, nutrients, and reparative cells to an injured area.
Infection. A common cause of delayed wound healing is infection. At the time of injury, microorganisms can enter the tissue. These microbes can delay wound healing by further prolonging the inflammatory process.
Slow-healing wounds, including leg and foot ulcers, are a known complication of several autoimmune inflammatory diseases, including rheumatoid arthritis (RA), lupus and scleroderma. For many people, these wounds can take months or even years to heal.
There are three main blood tests which need to be done any time a wound is slow to heal: HbA1C (to check for diabetes/pre-diabetes); full blood count (to check for iron deficiency anaemia); ferritin (a secondary marker for iron deficiency anaemia).
Poor Circulation
During the healing process, your body's red blood cells carry new cells to the site to begin rebuilding tissue. Poor blood circulation can slow down this process, making the wound that much longer to heal. Chronic conditions, such as diabetes and obesity, can cause poor blood circulation.
Eating well during wound healing helps you heal faster and fight infection. During healing your body needs more calories, protein, fluid, vitamin A, vitamin C, and zinc. The best source of these nutrients is food. If you are not eating enough healthy food, you may need to take a supplement.
When the body has an overabundance of cortisol, the high levels interfere with the production of anti-inflammatory substances called cytokines. The result is that your injured area remains inflamed and is very slow to heal.
Leg Wounds. Leg and foot wounds that don't heal normally may be a sign of an underlying circulation issue. The problem may be either arterial (delivering oxygen and nutrients to the affected area) or venous (removing toxins and fluids).
Although not an all-inclusive list, some of the more common complications include infection, tissue necrosis and gangrene, periwound dermatitis, periwound edema, osteomyelitis, hematomas, and dehiscence.
Wounds generally heal in 4 to 6 weeks. Chronic wounds are those that fail to heal within this timeframe. Many factors can lead to impaired healing. The primary factors are hypoxia, bacterial colonization, ischemia, reperfusion injury, altered cellular response, and collagen synthesis defects.
Wounds need to be covered so that they can heal properly. When a wound is left uncovered, the new surface cells that are being created can easily dry out. When these important cells dry out, it tends to slow down the healing process. A wound should be covered using a clean bandage.
This is partly due to the effect of aging on the cells within the body. In many elderly patients, cells divide more slowly or in some cases not at all (a condition referred to as senescence). The body also has a more difficult time producing fat cells under the skin.
Redness. The area may be swollen, sore, and red in color right after you've sustained your injury. This is normal as blood is being sent to the area to supply oxygen and other nutrients for healing. But if the wound is still red and swollen after five days, it's a sign that your body is not healing correctly.
Such non‐healing wounds result in infections, loss of function, and financial loss and are often the cause of tissue defect or sepsis. These wounds often occur secondary to factors such as aging, obesity, and diabetes.
Medications That Affect Wound Healing
Medications that have been reported to delay wound healing include anticoagulants, antimicrobials, various antibiotic classes, bevacizumab, aflibercept, antineoplastic agents, chemotherapeutics, immunosuppressants, and colchicine.
Deeper lacerations may take several weeks and even months to completely heal, and they may require stitches and other treatment from medical professionals to prevent complications and scarring.
Healing: To promote healing, cells of the immune system such as T-helper cells produce the cytokine protein IL-22, which signals the epithelium to re-grow and re-seal the injured site. IL-22 also stimulates production of antimicrobial peptides to further protect the injured area from bacteria.
Don't use hydrogen peroxide or iodine to clean the cut. They are harmful to the skin and can actually delay healing. Don't leave a cut or scrape exposed to the air. A bandage can protect the area from rubbing against clothing and getting dirt and bacteria in it, while keeping the cut moist to heal faster.