Wound healing is a complex, dynamic process consisting of three overlapping steps: inflammatory, proliferative and remodeling. Slow healing or non-healing wounds get stuck in one of these wound healing steps. These wounds usually have not healed within a month and may only heal with the assistance of medical intervention. In the March 2003 issue of the "British Journal of Dermatology," researchers estimated that 3 to 5 percent of people over the age of 65 years would suffer from a slow or non-healing leg wound. Multiple factors influence and affect healing.
Diabetes
The American Diabetes Association estimated that approximately 15 percent of diabetics would develop a foot ulcer, which is a non-healing wound, at a 1999 medical conference and later in the journal "Diabetes Care." The side effects of diabetes have been well-documented and reviewed by Shinji Kawahito and colleagues, of the Department of Anesthesiology at Tokushima University Medical and Dental Hospital in Japan, in the September 2009 issue of "World Journal of Gastroenterology." Side effects of poorly controlled diabetes can delay wound healing by causing circulatory problems and nerve damage and altering the body's ability to fight infection.
Malnutrition
Wound healing requires adequate nutrition, as malnourished people often have slow or non-healing wounds. A scientific review published in May 2008 in the journal "Current Opinion in Clinical Nutrition and Metabolic Care" demonstrated the need for adequate nutrition to allow the formation of new tissue and for this tissue to be strong enough to allow normal use after repair. Many components of a healthy diet are required to promote wound healing. Protein and carbohydrates are needed for the energy source and repair of the body, while vitamins, especially vitamin C, are required for collagen metabolism.
Infection
A study published in the January 2008 issue of "Wound Repair and Regeneration" found that chronic or non-healing wounds contain a film of bacteria called biofilm. These bacteria are difficult to eradicate, as they are often resistant to traditional antibiotics. Slow or non-healing wounds often contain high numbers of bacteria, which can produce chemical signals. These chemical signals break down the newly healing tissue and prevent the accumulation of new collagen required for wound healing.
References
- "British Journal of Dermatology"; Causes, Investigation and Treatment of Leg Ulceration; J.R. Mekkes et al.; March 2003
- American Diabetes Association; "Diabetes Care"; Consensus Development Conference on Diabetic Foot Wound Care; August 1999
- "World Journal of Gastroenterology"; Problems Associated With Glucose Toxicity; Role of Hyperglycemia-Induced Oxidative Stress; S. Kawahito et al.; September 2009
- "Current Opinion in Clinical Nutrition and Metabolic Care"; Assessment and Nutritional Aspects of Wound Healing; A.C. Campos et al.; May 2008
- "Wound Repair and Regeneration"; Biofilms in Chronic Wounds; G.A. James et al.; January-February 2008
