Pain is an essential indicator of poor wound healing and should not be underestimated. Pain can occur from the disease process, surgery, trauma, infection or as a result of dressing changes and poor wound management practices.
In general, non-healing wounds share similar characteristics: high level of proteases, elevated inflammatory markers, low growth factor activity, and reduced cellular proliferation [3].
Wound healing can be delayed by factors local to the wound itself, including desiccation, infection or abnormal bacterial presence, maceration, necrosis, pressure, trauma, and edema.
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.
Healthy granulation tissue is pink in colour and is an indicator of healing. Unhealthy granulation is dark red in colour, often bleeds on contact, and may indicate the presence of wound infection.
The factors discussed include oxygenation, infection, age and sex hormones, stress, diabetes, obesity, medications, alcoholism, smoking, and nutrition. A better understanding of the influence of these factors on repair may lead to therapeutics that improve wound healing and resolve impaired wounds.
In non‐healing wounds, foreign bodies can be diagnosed in the postoperative period owing to pain, infection, palpable mass, or during radiological imaging. Computed tomography is generally used in patients with suspected foreign bodies.
Zinc is a trace element, found in small amounts in the body, which plays a role in wound healing. Zinc is involved in protein and collagen synthesis, and in tissue growth and healing. Zinc deficiency has been associated with delayed wound healing, reduced skin cell production and reduced wound strength.
Fever, chills, malaise) and local signs, such as increased wound size and depth, purulence with increased pus or drainage from wound fluctuance, crepitus, devitalised tissue, worsening swelling, spreading cellulitis or malodour.
Whether it's a surgical wound or one that seemed minor at first but is getting worse instead of better, any wound that's infected should be evaluated by a medical provider. Signs a wound may be infected include: Increasing pain or redness. Drainage or bleeding that won't stop.
Good circulation, both arterial and venous, is essential for good wound healing. Anaemia, regardless of type, reduces the capacity of the blood to provide oxygen to the tissues, since haemoglobin transports oxygen to the cells. Normal immune system function is required for the inflammatory phase of healing.
Wound healing is classically divided into 4 stages: (A) hemostasis, (B) inflammation, (C) proliferation, and (D) remodeling. Each stage is characterized by key molecular and cellular events and is coordinated by a host of secreted factors that are recognized and released by the cells of the wounding response.
Debridement. Debridement is the most common treatment for stubborn to heal wounds, and involves the removal of unhealthy tissue within a chronic wound to promote the growth of healthy tissue, reduce complications of infection, and speed up the healing process.
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.
When a wound heals healthily, the tissue does not bleed easily. Whilst you are observing the wound, look for a red or pink colour – this shows it is healing effectively. Dark tissue, however, could be indicating an infection.
Gently wash the area with mild soap and water to keep out germs and remove debris. To help the injured skin heal, use petroleum jelly to keep the wound moist. Petroleum jelly prevents the wound from drying out and forming a scab; wounds with scabs take longer to heal.