The term wound healing disorders refers to general difficulties in natural wound healing. These can occur for a wide variety of reasons, such as previous illness or incorrect wound care.
What are wound healing disorders?
Medical professionals speak of wound healing disorders whenever there are difficulties or delays in the natural healing of wounds. Basically, the body tries to replace tissue injured by violence or disease with healthy tissue as quickly as possible. Due to various causes, however, the healing process can be disturbed. This is a strain on the organism, especially since there is a constant risk of inflammation of the open wound. Particularly in the case of very large and serious wounds, for example after an operation, life-threatening conditions can result. Surgical interventions must therefore be weighed carefully in the case of certain diseases.
Causes
The causes of wound healing disorders can be varied. In principle, wounds heal better in young people than in older people. Often, incorrect wound care is also responsible for the impaired healing process. For example, if the wound was not closed perfectly after an operation or if the stitches are removed too early, it cannot close optimally. The patient’s individual state of health can also affect wound healing. Diseases such as diabetes, tuberculosis, HIV or a drug addiction can cause wound healing problems, as can certain medications. Protein deficiency, vitamin deficiency or severe obesity are other factors that can lead to problems with wound healing. The attending physician should therefore always take the patient’s lifestyle into account when making a diagnosis.
Symptoms, complaints and signs
Wound healing disorders can have serious consequences. Therefore, it is important to pay attention to the first signs of a wound healing disorder. This will allow prompt professional treatment by a medical professional. Some clinics have specialized staff to provide wound care for amputation-related and other wound healing disorders. The most important symptom of wound healing disorders is that an open wound simply will not heal. This may be an open leg, an amputation or surgical scar, or some other type of wound. The wound defect can show up in different ways for a while. The wound may ooze or bleed without showing sufficient signs of healing. The area around the wound may be very painful, swollen or discolored. In addition to wound healing problems, nerve, bone, vascular damage sometimes occurs. If blood and lymph circulation in the wound area is disturbed, lymphedema and other sequelae may occur. Wound infections may develop. Their symptoms are a foul odor, a purulent layer on the wound and redness in the wound area. There is pressure pain around the open wound. Fever may indicate the onset of sepsis. The leading symptoms of wound healing disorders are delayed healing, redness, hyperthermia, tenderness or swelling. The wound may ooze, bleed, or ulcerate. There is pain in the wound area and sometimes restriction of movement.
Diagnosis and course
In most cases, wound healing disorders can be diagnosed directly by the attending physician visually. By looking at and examining the wound, he can determine how old it is and to what extent it should have already healed as part of optimal wound healing. If a wound healing disorder is actually present, the exact causes must be determined. For this purpose, both the wound care and the patient’s living conditions should be examined more closely. If a wound remains untreated when the healing process is disturbed, severe inflammation can occur. In the worst case, this can threaten the patient’s life, especially if the wound is large. Appropriate medical care is therefore essential.
Complications
Wound healing disorders are considered a dangerous complication of surgery, injury, and underlying diseases. They occur especially in people with weakened immune systems or as a result of diabetes mellitus and severe skin diseases.However, incorrect position after surgery or incorrect treatment of the wound can also lead to disruption of healing. With optimal wound treatment, the chances of healing are good. However, recurrences can sometimes occur. The prognosis of a wound healing disorder also worsens if it is caused by an underlying disease. In this case, complete healing of the wound is only possible if the triggering disease is also successfully treated. Wound healing disorders can lead to serious complications. If the wound is not or insufficiently disinfected, there is often a rapid multiplication of pathogens that penetrate the wound. Pus foci develop, which in very unfavorable cases can lead to potentially fatal sepsis. Furthermore, wound healing disorders are often the cause of chronic nerve, vascular, muscle, tendon or bone damage. A particularly feared complication of wound healing disorders is the so-called compartment syndrome. In this case, the tissue pressure in the musculature increases due to outflow disturbances of the venous blood. The following blood circulation disturbance can interrupt the arterial blood flow into the musculature. Particularly in the lower legs, feet, or forearms, muscle tissue death then frequently occurs.
When should you see a doctor?
Under optimal conditions, the discomfort of a wound diminishes over several days or weeks in a continuous process. If improvement in health can be perceived daily, no physician is needed. Tension often occurs during movement because the skin of the wound has not yet fully regenerated and, consequently, is not sufficiently stretchable. This is a natural process that does not require further medical attention. A doctor is needed if the wound healing process does not progress further for several days. In addition, consultation with a physician should be made if there is increasing discomfort. Swelling and discoloration of the skin should normally decrease steadily. However, if they increase or pain occurs, action is required. If there is irritation of the skin around the wound, action is also required. In particularly severe cases and if the healing process is unfavorable, blood poisoning may occur. Therefore, a hospital must be visited or an ambulance service alerted if severe pain occurs, intense discomfort develops or edema forms. Sensitivity to pressure in the area of the wound is normal. However, consultation with a physician should be sought if the tenderness becomes more intense or the affected area enlarges.
Treatment and therapy
After comprehensive examination and diagnosis by the attending physician, the first priority is to clean the wound. It must be thoroughly cleaned and disinfected to prevent dangerous inflammation. Various irrigation solutions are available for this purpose. Under certain circumstances, it may be necessary to surgically remove the already dead tissue and then suture the wound (again) so that healing can take place. Generally, wounds are nowadays covered extensively with compresses so that the natural healing process cannot be impaired by external influences. These dressings must be changed regularly. In addition, coagulation-supporting drugs may be administered under certain circumstances. In addition to acute care, the underlying causes of the wound healing disorder should also be determined, ideally before therapy is initiated. In the case of certain diseases, special treatments may be necessary or some medications may not be used. If the reasons for impaired wound healing lie in the patient’s lifestyle, administered nutrients or vitamins can usually provide a remedy quite quickly. If diabetes is already present, the blood sugar level should always be regulated to a reasonable level. If inflammation of the wound has already occurred, it must be treated quickly with medication or possibly surgery to prevent life-threatening conditions from developing.
Prevention
Wound healing disorders can be prevented in many cases by optimal and professional wound care. Therefore, utmost importance should always be attached to this.Risk factors such as obesity or a lifestyle that favors deficiency symptoms should be minimized to prevent major problems in the healing process in the event of a wound. If underlying diseases such as diabetes are present, appropriate treatment of these is urgently required. If a wound does not heal quickly and without problems as usual, a visit to the doctor is strongly advised.
Aftercare
Various complications occur with wound healing disorders. However, aftercare in this case should not be based solely on the original wound. First, it must be ensured that the wound does not become inflamed or that inflammation is detected and treated as quickly as possible. In addition to local measures, it may also be necessary here to take certain medications, such as antibiotics. It is therefore important to have the wound healing regularly monitored by a doctor. The second pillar of aftercare is to determine the cause of a wound healing disorder. In some cases, previously unrecognized systemic diseases (e.g., diabetes) are responsible, as is extensive cigarette use. It is important to treat the actual cause, otherwise the recurrence of wounds can lead to wound healing disorders, which are increasingly difficult to treat – even according to the type and location of the wound. The patient should work with an experienced medical professional for advice and treatment for the individual case. The wound itself should be cared for until it is completely healed, dressed if necessary, and kept away from sources of infection. Re-injuring can also lead to significant complications, and sparing of the affected areas of the body is also advised during aftercare until a certain point.
This is what you can do yourself
If wound healing is disturbed, increased care should be taken in everyday life when performing movements. Feelings of tension should always be avoided in the area of the wound. Therefore, stretching or performing stretching exercises are not recommended. Physical exertion must be adapted to the health possibilities. Therefore, it is necessary to check which sports activities can be performed and which occupational activities can be fulfilled in the current health situation. Situations of overexertion or heavy physical strain have a disruptive effect on the recovery process and must be refrained from. The organism can be supported in healing by a healthy and balanced diet. A diet rich in vitamins, sufficient oxygen supply and avoiding the consumption of harmful substances help in this process. The immune system is thereby supported and can promote the regeneration process more strongly. Adequate sleep and regular rest have also proven helpful. Breaks should be taken at regular intervals and the wound should be checked several times a day. The wound dressing must be changed in a sterile manner. If necessary, the help of nursing staff should be sought. If possible, the physical region around the existing wound should be kept still. As a result, assistance from others is often needed to perform daily tasks.
