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Five reasons wounds won’t heal

A wound or sore is a cut or break in the skin. There are many reasons one can have a wound, and they are common. According to the United States Centers for Disease Control and Prevention, it is estimated that nearly 6.7 million Americans suffer from chronic wounds, which also cost the healthcare industry more than $50 billion a year. Non-healing wounds are very common in persons living with diabetes.

Wound healing is a complex process that must occur in a specific order. In addition, there are specialized cells in the body that are needed at precise times to make sure the wound heals. A chronic wound is one that has failed to progress through the phases of healing in an orderly and timely fashion and has shown no significant progress toward healing in 30 days. If a wound has not improved significantly in four weeks or if it has not completed the healing process in eight weeks, it should be considered a chronic wound. It does not matter what type of wound, the cause of the wound or where the wound is, it can become a chronic wound.

Chronic wounds may take a long time to heal, even years or never heal. These wounds cause many patients emotional and physical pain and create a significant financial burden on patients and the whole healthcare system. There are several factors that can contribute to wounds being chronic. These may include pressure or trauma, infection, too much cells that slow wound healing, wound environment not promoting healing, and inappropriate treatment.

Reason why many wounds don’t heal

Poor nutrition: Patients with chronic wounds need to pay special attention to their diets. It is important for the person with wounds to eat a balanced diet with good quality protein, more veggies and fruits and less processed foods and sugar. When the body is working to heal a wound, it takes up to three times the normal daily requirement of protein. Adequate protein and vitamins and minerals like vitamin C are needed for wound healing because they help repair and make new skin. When you see the wound care specialist they may order tests to check your nutrition, recommend improving your diet or supplements or even refer you to a nutritionist to help plan your meals.

Infection: All wounds have bacteria in them. In fact, we also have bacteria on our skin. When the number of bacteria increases it stops wounds from healing because all the energy is spent on fighting the infection rather than healing the wound. Infections can slow or even stop the wound healing process. People who have infected wounds often present with redness, swelling, increased odor, drainage, and pain to the wound. They can also be fever and chills, and if people have diabetes their sugar may also be high. This is the reason such infections must be treated right away. The doctor will take a wound culture to find out which bacteria are growing on the wound and order antibiotics to treat and get rid of the infection.

Poor circulation: Without blood flow the wound will not heal. Blood brings healing cells to the wound so if your circulation is poor, that process doesn’t work as well. If the doctor finds there is low or no blood flow to the wound with no pulse or other signs of low blood flow, you will be sent to see a vascular doctor who will evaluate and treat by trying to bring more blood to the area. This may include medications or even surgery to open the arteries that bring blood to the wound.

Excessive swelling: Edema or swelling occurs when fluid leaks from blood vessels and accumulates in nearby tissue. Swelling impairs the body’s ability to heal by restricting oxygen getting to skin where it is needed for normal healing. Elevation or raising the area above the heart is good to help with decreasing the swelling and increasing healing.

Pressure: Pressure occurs when persons stay in one position for a long time which damages the skin and causes it to break. For example, people who are on bed rest for a long period of time need to be moved regularly to heal and prevent pressure sores. The same goes for those who have spinal cord injuries or who are paralyzed in their lower body. Diabetics with neuropathy and foot deformities have increased foot pressures leading to ulceration. A special bed mattress can also be used to relieve the pressure – and for diabetics, special pads, shoes, insoles, debridement of calluses and even surgery may be needed.

Other reasons wounds may not heal may be leaving the wound “open to the air”. This is not recommended because it dries out the wound and slows healing. No treatment or inappropriate treatment can also slow wound healing. If you have a wound, you should be treated by a specialist. Seeing a wound specialist is proven will speed wound healing. Wound specialists are healthcare professionals who have been trained in the care and treatment of all types of wounds, acute and chronic. Among the most commonly treated wounds are those sustained from an acute injury, surgical wounds, diabetic wounds and pressure sores. They also use the most advanced techniques, products and services to help heal the wound.

• For more information or to see a podiatrist, visit Bahamas Foot Centre Rosetta Street, telephone 325-2996; or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820; or email foothealth242@hotmail.com; or visit www.apma.org.

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