What is a non healing wound?
Non-healing wounds, also called chronic wounds, are those that fail to heal within the usual period of four weeks to three months. These wounds heal at a slow pace and tend to recur. Some common non-healing wounds are diabetic foot ulcers, ischemic wounds, venous leg ulcers, and pressure wounds. There are many causes behind non-healing wounds, such as infections or medical conditions like diabetes. An estimated 1–2 % of the population in developed countries will suffer from non-healing wounds in their lifetime. This number is expected to rise, given the increase in the incidence of diabetes and obesity. People suffering from non-healing wounds experience not only physical discomfort and pain but also mental stress, increased morbidity, and financial burden.
How to know you have a non-healing wound
You know you have a non-healing wound when you notice the following signs:
- Thick discharge: Yellow or green pus or excessive clear fluid at the wound site, along with redness and extreme pain
- Redness or warmth around the wound: The injury starts spreading, and you notice redness around it. The area feels warm. These are the signs of an infection.
- Bad odor: An unpleasant odor from the wound indicates dead tissue.
- Swelling and redness: The area near the wound swells and appears red, which is a sign of a bacterial infection
- Bleeding: Non-stop bleeding of the wound for ten minutes after applying direct pressure
- Darkening skin: Skin begins to darken at the edges — this is a sign of dead tissue.
- Fever: The patient suffers from a fever of over 100 degrees Fahrenheit lasting over four hours.
Causes of non-healing wounds
Non-healing wounds cause physical pain, stress and anxiety, social stigma, financial expenses, disability, and loss of productivity. These fail to heal in the usual timeline of four weeks because of several underlying reasons that have been untreated. Patients having non-healing wounds usually suffer from comorbidities. The leading causes of non-healing wounds are:
- Infections: Bacterial, viral, or fungal infection in or around the wound hinders the healing of the wounds. If the infection originates near the bones, it comes up to the skin surface and forms a lesion. When bacteria multiply at the site, the wound gets infected, and the healing process is hampered.
- Poor circulation: A proper blood flow delivers nutrients and oxygen to the wounds. It also helps remove bacteria and toxins from the area. However, diseases such as diabetes, high blood pressure, and peripheral vascular disease hamper blood flow. This causes slow healing of wounds.
- Wound condition: Healing of wounds is affected by repeated trauma, such as bumping or rubbing against the wound area or pressure to the wound site. A lack of movement can also cause non-healing wounds.
- Medications: Drugs such as corticosteroids that impede inflammation, radiation therapy, and drugs used for chemotherapy increase the risk of infection and non-healing of wounds.
- Age: Older adults have fragile skin, which is likely to get infected sooner. Their bodies also do not produce enough antibodies to fight infection. The presence of diabetes or heart disease leads to poor circulation, all of which causes non-healing wounds.
- Diabetes: Diabetes affects the ability of the skin to heal itself. High blood glucose levels weaken the functioning of white blood cells. This incorrect functioning of the white blood cells disrupts the body’s ability to fight bacteria and heal wounds.
Therapies to consider for non-healing wounds
Regular cleaning of non-healing wounds, their dressing, and bandaging is crucial. Besides this, the following processes and therapies are conducted in treating non-healing wounds:
- Debridement: Debridement is the removal of dead tissue using instruments like tweezers, curettes, or scalpels. After removing the dead tissue, an enzyme-based gel is applied over the wound. Another form of debridement consists of using specific maggot or fly larvae species. These maggots are placed on the wound, which remove the dead tissue from the wound.
- Antibiotics: Antibiotics in the form of ointments are prescribed for diabetic foot ulcers, which help heal wounds faster. However, antibiotics in the form of tablets haven’t shown any advantages in healing these wounds.
- Hyperbaric oxygen therapy: The patient is placed in a special room to breathe in oxygen under high pressure as part of this therapy. It increases the oxygen concentration in the blood, which enhances the blood supply to the wounded area.
- Ultrasound and electromagnetic therapy: In ultrasound therapy, the wounds are treated using sound waves, making the tissue warmer. In electromagnetic therapy, weak electromagnetic waves are applied to the wound using pillows that contain magnets.
- Negative pressure wound therapy: This therapy is also called vacuum-assisted closure or VAC therapy. In this therapy, the wound is covered in an airtight dressing, which is then connected to a pump with a thin tube. The pump sucks the fluid out of the wound, creating a negative pressure across the wound. This, in turn, helps increase blood flow to the wound site. In this therapy, the wound stays moist, which improves the healing process.
- Consult a wound care specialist: Wound care specialists offer bedside wound management services to patients with non-healing wounds. They are a team of specialists who provide early detection and treatment of chronic wounds, apart from any necessary therapy.
What makes wounds not heal?
The following reasons lead to the slow healing of wounds:
- Poor circulation: Chronic conditions like diabetes and obesity cause poor blood circulation. As a result, the red blood cells can’t carry new cells to the wound site for rebuilding the tissue.
- Infection: In case of an injury, bacteria enter the body through the open wound. The body tries to fight the infection instead of healing the wound, which leads to non-healing wounds.
- Edema: Fluid accumulation or edema restricts oxygen to the wound, weakening the body’s ability to heal the wound.
- Inadequate nutrition: Lack of proper nutrition, such as foods high in proteins and ample water intake, also affects the body’s ability to heal wounds.
- Repetitive trauma to the wound: If the patient isn’t able to change positions often, or when the wound is subjected to repetitive pressure or trauma, it slows down blood circulation. This leads to the non-healing of wounds.
Several reasons, such as chronic diseases, lack of nutrition, fluid accumulation, etc., lead to non-healing wounds. Regular cleaning and dressing of such wounds are essential. However, patients can also try different therapies after consulting with their doctors. For people with non-healing wounds, lifestyle and dietary changes to control conditions such as diabetes and obesity are crucial. Staying well-hydrated, consuming the right supplements, and maintaining blood sugar levels will help wounds heal faster.
How long is too long for a wound to heal?
Wounds usually take four weeks to three months to heal. But if there is no significant improvement in a wound after a few weeks, or it has not healed even after the stipulated three months, it is considered a chronic or a non-healing wound.
Do blood thinners cause slow healing?
Patients suffering from comorbidities require anticoagulants or blood thinners. These drugs delay blood clotting and help prevent heart attacks. However, as these drugs thin the blood, they lead to excessive bleeding and hamper the healing of wounds.
How can I make my surgical wound heal faster?
It is vital to provide the body with enough proteins and fluids to help enhance the healing process of surgical wounds. Mild activity is also essential to improve the blood flow that supports healing. Wearing comfortable clothing that doesn’t irritate the wound site and regularly changing the wound dressing will help the wounds heal faster after surgery.