Wound healing disorders

Disturbances in wound healing can be caused by infections (bacterial) or haematoma formation. Both should be treated as quickly as possible by cleansing and antibiosis (infection) or by puncture or opening the skin suture (haematoma). The scar itself can heal without complications, or it can form more kelloid.

This leads to increased formation of connective tissue, which in turn leads to unsightly scar growths in the area of the scar and beyond. With scar hypertrophy, scar growths occur only in the area of the scar. Another complication is scar rupture due to infection or suture failure. The scar bursts open and must then be closed again.

Promoting wound healing

In order to ensure optimal wound healing, in addition to good wound care, various supporting measures can be taken independently. Error-free wound care primarily includes the application or implementation of suitable hygiene measures (hand disinfection, wound cleaning with Ringer’s solutions, wound disinfection) during the treatment of the wound area in order to prevent the penetration of germs and a resulting infection of the wound. In addition, the wound area should be closed with suitable wound dressings, whereby in most cases moist wound environments should be created (e.g. with hydroactive wound dressings in the form of plasters or gels).

This ensures that the healing process is optimized, a barrier against microorganisms is formed and the drying out of the wound area and scab formation is prevented, thus reducing scarring and itching during wound healing.In order to additionally promote wound healing, a sufficient, balanced diet should also be taken into account that every healing process requires an increased need for energy and nutrients. In addition to a sufficient fluid intake to promote the blood circulation in the wound area and the accumulation of defence cells and nutrients, a sufficient supply of proteins, carbohydrates, fats, vitamins (A,B,C), trace elements (zinc, copper, manganese, iron) is also necessary. Overweight or underweight conditions as well as deficiencies can therefore lead to wound healing disorders.

Furthermore, the body part affected by the wound – especially wounds over joints – should be kept still during the healing process and scratching or removal of forming scabs or crusts should be avoided. Direct sunlight on fresh wounds should also be avoided. Smoking should also be avoided, as the nicotine in cigarette smoke has been shown to interfere with or slow down the healing process (through reduced blood circulation, reduced oxygen supply and delayed cell regeneration).

Heat can also have a positive influence on wound healing, as it leads to an expansion of the vessels and an improved blood circulation situation in the wound area (e.g. by using infrared heat lamps). Should an infection nevertheless occur due to bacterial colonization of the wound, so that the healing process is made more difficult and delayed, the local or systemic administration of an antibiotic by the treating physician can steer the course back into the right direction. The healing of wounds after an operation is very important.

It is important to note that the scar is covered with a sterile plaster in the first few days in order to minimize the number of germs. In addition, the affected area of skin should be subjected to little stress, i.e. the skin should not be excessively stretched or strained. After an operation it is important to always check the scar.

It is optimal if the wound is not at all to slightly reddened and the wound edges are dry. If the wound edges are reddened and wet, this can be a sign of inflammation. To ensure optimal wound healing after an operation, alcohol and smoking should be avoided during this time.

It is precisely the ingredients of a cigarette that weaken the blood circulation of the skin and thus make healing more difficult. Another reason for a wound healing disorder can be a bad suture. If the edges of the wound are not sewn together well, this can also delay the healing process.

If there is a lot of subcutaneous fatty tissue, wound healing can take longer, as the fatty tissue has a poorer blood supply than the rest of the skin. In addition, an infection of the affected region can be the reason for a wound healing disorder. No ointments or similar should be applied to fresh surgical wounds.

The plaster should be changed daily and no water should be applied to the wound in the first few days. In contrast to other parts of the body, the healing of wounds in the anus is more difficult. On the one hand, there is a much higher bacterial colonization, on the other hand, the wound here is partly exposed to mechanical stress.

Wound healing can be accelerated by maintaining hygiene. For example, the wound should be cleaned after each visit to the toilet. This can be done with an antibacterial soap on the bidet, or with antibacterial wet wipes.

Care should be taken to ensure that the cleaning is also carried out outside the toilet in the morning and evening. In addition to hygiene, care must be taken to ensure that the wound is not manipulated. This worsens the wound healing. In addition, as with any wound, healing can be accelerated here with an iodine cream.