When we are young, we do not worry too much about minor nicks and scrapes as they heal on their own, with just a bandage and some TLC. However, as we age, the healing process slows down as the body’s capacity to repair starts diminishing.
The stem cells and growth factors reduce over time, and this impacts the healing elements. Having chronic diseases and even malnutrition can also slow down the healing process.
Reasons For Slow/Non HealingWhile there may be numerous reasons why a wound has not healed or is healing slowly, the following are common reasons why a wound festers.
Infection:Against bacteria and other microorganisms, the first line of defense is the skin.
Any breakdown in the skin allows these pathogens to move inside the body, making the area infected. Once infected, the area becomes red, swells up, becomes painful and has foul-smelling or off-color fluid.
Diabetes:Diabetics have increased chances of getting infection and slow-healing wound as the increased blood sugars negatively impact the immune system and circulation.
The nerves present in the lower legs and feet get damaged due to diabetes leading to a person not knowing about the wound and causing the simple nicks and scrapes to become a festering wound.
Medication:Different types of medications can also cause a slower rate of wound healing.
Drugs for radiation and chemotherapy have potent chemicals that impact the immune system, which in turn makes healing a much more complicated process.
Antibiotics present in the drug often destroys good bacteria, increasing the risks of infection. Additionally, anti-inflammatory drugs also tend to inhibit the inflammatory process that a body goes through while the wound is healing.
Bed Sores:Bedsores or pressure ulcers occur when one becomes immobile or bedridden for an extended period.
A bedridden or an immobile patient will have pressure on different areas of the body which results in reduced blood supply to these areas. Reduced blood supply will result in the development of wounds that can become large and/or deep.
Once the wound reaches the bone, then the patient requires surgery to heal it.
Circulation:When a wound is getting healed, it has increased blood supply wherein the red blood cells carry new cells that form the foundation of the creation of new skin.
Poor circulation will mean that the blood will flow slowly which can delay the healing process. Poor circulation can be due to blood clots, obesity, diabetes, arterial build-up or any other underlying issue.
Venous Leg Ulcers:These happen due to slow healing of the wound. Most of the time, venous ulcers occur due to poor circulation in the veins present in the legs.
Nutrition:Do you have enough vegetables and fruits? The vitamins and nutrients present in these aid in faster healing.
Make sure to include items like spinach, oranges, bell peppers, and sweet potatoes in your diet. Also, add lean protein on the menu.
Alcohol:Alcohol consumption destroys white blood cells present in the wound that protects the body from bacteria.
Innovations in HealingInnovations in science have resulted in the development of new technologies that help in faster wound healing.
For instance, new technologies have allowed usage of stem cells, platelet-rich plasma, decellularized skin, and human placental material in wound healing. However, these are very costly and do not have insurance coverage which has resulted in them to stay out of the reach of the common man.
Another treatment is the use of oxygen through the hyperbaric oxygen chamber. Even though it is widely used, the efficacy has not yet been established.
The Healing ProcessA combination of approaches is needed while dealing with a stubborn wound. A patient would require the services of a wound care specialist (certified wound nurse, specialty-trained PA, physician) to address the injury.
The first step in addressing a slow-healing wound is debridement, a process that removes the dead tissues that impair cell growth. Regular debridement might be necessary if the tissue continues dying.
Wound healing also involves using special dressings (according to the patient’s need) to create a more appropriate environment for wound healing. In certain severe cases, the patient might have to undergo skin grafting.
Wounds specialists also use wound VAC (vacuum-assisted closure) to heal the wound. Wound VAC involves suctioning out fluids and stimulating healthy cells. Wound VAC promotes blood vessels to grow in the new tissue. Wound VAC is typically used after debridement of a large wound.
Unfortunately, pharmaceutical companies have not been able to come up with an effective medication for slow-healing wounds. The only one to pass the US FDA muster is a topical gel called Regranex (becaplermin). However, this medication does come with a cancer warning.
Other Treatment StepsTreatment of a slow-healing wound does not always happen in a doctor’s office. A patient can take steps like:
Offloading.Avoiding pressure on the wound allows the blood to start flowing back to the area. Offloading techniques depend on wound location.
Exercise.When a patient walks, the pressure on the wound is reduced to a great extent, and the body is stimulated to initiate the healing process.
Supplements.Zinc and vitamin C play a vital role in the multiplication of cells. A regular multivitamin is enough for a majority. If the wound is still not healing, a nutrient check may be advisable.
Healthy diet.Having proper nutrition is also essential for proper wound healing. Nutrients packed in the food are a potent source.
Protein (both animal and plant-based) provides amino acids that are necessary for regenerating the skin. A healthy diet should also include different types of vegetables, low-fat dairy foods, whole grains, and some fruits.
PreventionEating right, exercising, and switching positions play a significant role in not only increasing the rate of wound healing but also preventing the new wound from cropping up.
Proper screening for medical conditions like diabetes and getting it under control as well as regular checking for venous insufficiency ulcers, is also an important preventative step.
Also, skin moisturization helps in keeping dry skin at bay which can promote pressure wounds.