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Here at Wound Care Solutions we talk a lot about wounds (duh), but it’s not just because it’s in our name, it’s because the world of wounds – how to treat them, and most importantly, how to prevent them – is inextricably linked to good health. When your body is busy fighting infection and trying to heal a wound, it’s draining important resources away from healing other ailments. Our mission is to help keep patients wound-free so they can continue along the road to recovery without additional obstacles.
Before we can jump into why your body might not be healing as quickly as you’d like, however, we need a little background on wounds – why they happen and how they heal.
According to this abstract from the Mayo Clinic, “human skin is a remarkably plastic organ that sustains insult and injury throughout life.” Indeed, our skin is under constant stress, from sun, smog, friction, tension, temperature, and a heap of other external factors. When there is sufficient stress to cause injury, we get a wound.
Wounds can be classified in a number of ways:
Open vs. Closed
Open wounds are wounds with exposed underlying tissue, open to the outside environment. Closed wounds have damage that occurs without exposing the underlying tissue and organs.
Acute vs. Chronic
Wounds are classified as acute or chronic depending on how long they take to heal. Acute wounds heal without complication in a relatively predictable amount of time. Chronic wounds take longer to heal and often involve some complications.
Clean vs. Contaminated
Clean wounds have no foreign materials or debris inside. Contaminated wounds (also known as infected wounds) might contain dirt, bacteria or other foreign materials.
A pressure wound (something we cover a lot in our blog in posts like this and this) may be an example of an open or closed wound (depending on what stage it’s at) and is often classified as chronic, that is, taking a longer time to heal and involving complications.
Wounds generally go through three stages as they repair (but remember, wound healing is not linear and wounds can progress both forwards and backwards through the phases on the road back to health).
During the Inflammatory Phase the body produces a natural response (inflammation) to the injury and forms a clot to stop the bleeding. Blood vessels dilate to allow essential cells (e.g. antibodies, white blood cells, growth factors, enzymes, and nutrients) to reach the wounded area. These cells create swelling, heat, pain, and redness, or the “inflammation” for which the phase is named.
The Proliferation Phase is when the wound is rebuilt. The wound contracts as a new network of blood vessels are constructed so that the tissue can receive sufficient oxygen and nutrients. In healthy stages of wound healing, the tissue is pink or red and uneven in texture and does not bleed easily. Dark tissue can be a sign of infection. Near the end of the proliferative stage, new skin cells resurface the injury.
Finally, the Maturation Phaseis when the wound fully closes and the scar begins to fade. This “remodelling” generally begins about 21 days after an injury and can continue for a year or more, however the healed wound area will always be weaker than the uninjured skin, generally only regaining 80% of the original tensile strength.
Alright, now that we know a bit about wounds, let’s take a look at seven factors that affect their healing.
As we’ve already read, wound healing is not a straight line from A to Z - wounds can progress both forwards and backwards on the road back to health, and how they do so will depend on several outside factors.
Aging affects everything in the body and (as anyone who’s ever read a beauty magazine already knows) that includes the structure and function of the skin. Everything slows down during the aging process, including the phases of wound healing. Skin gets thinner and the body shows a decreased inflammatory response meaning that, as you get older, your skin is predisposed to injury and will heal slower when injury occurs.
Proper nutrition is vital to optimal healing. A wound is unable to heal properly if you lack the necessary nutrients for cell repair and growth.
Anyone surpassing their ideal body weight by 20% or more has a greater risk of infection when healing a wound.
If you have multiple wounds or have undergone a severe trauma (e.g. surgery) your body’s defense mechanisms will be limited and slow wound repair.
Skin needs an adequate amount of fluid and moisture to be viable. If you’re prone to dry skin (especially common in the elderly) you may be at risk for skin lesions, infection, and thickening, which will all impair wound healing. On the flip side, if the skin is too wet, you’re at risk for developing maceration and/or infections, so maintaining an optimal level of skin moisture is imperative for healing wounds.
Chronic diseases have a direct impact on the body’s natural ability to heal. Cardiovascular conditions are among the most detrimental, but diabetes and immunodeficiency conditions can also slow wound repair.
Prescription medications can have a negative effect on healing. For instance, according to the American Academy of Orthopaedic Surgeons, nonsteroidal anti-inflammatory drugs often prescribed for arthritis and found over the counter as aspirin and ibuprofen, can interfere with the inflammation stage of the healing process. Anticoagulants have the capacity to disrupt blood clotting, while immunosuppressants may weaken the immune system and enhance the risk of infection.
Wound Care Solutions is your partner in wound health. Our mission is to keep patients at home, healthy, and out of the hospital. Visit us today to learn more.