Dryness – wounds (such as leg ulcers) that are exposed to the air are less likely to heal.Varicose veins – restricted blood flow and swelling can lead to skin break down and persistent ulceration.Smoking – cigarette smoking impairs healing and increases the risk of complications.Medicines – certain drugs or treatments used in the management of some medical conditions may interfere with the body's healing process.Age – wounds tend to take longer to heal in elderly people.Medical conditions – such as diabetes, anaemia and some vascular diseases that restrict blood flow to the area, or any disorder that hinders the immune system.Diet – poor food choices may deprive the body of the nutrients it needs to heal the wound, such as vitamin C, zinc and protein.Mechanical damage – for example, a person who is immobile is at risk of bedsores because of constant pressure and friction.Haemorrhage – persistent bleeding will keep the wound margins apart.The body fights the infection rather than healing the wound. Infection – an open wound may develop a bacterial infection.Dead skin (necrosis) – dead skin and foreign materials interfere with the healing process.This is why scars tend to fade with time and why we must take care of wounds for some time after they have healed.īarriers to wound healingFactors that can slow the wound healing process include: Maturation stage – the body constantly adds more collagen and refines the wounded area.Small blood vessels (capillaries) form at the site to service the new skin with blood. The growth of collagen encourages the edges of the wound to shrink together and close. Fibroblastic stage – collagen, the protein fibre that gives skin its strength, starts to grow within the wound. Skin cells multiply and grow across the wound. White blood cells flood the area to destroy microbes and other foreign bodies. This is why a healing wound at first feels warm and looks red. Once the clot is completed, blood vessels expand to allow maximum blood flow to the wound. Inflammatory stage – blood vessels at the site constrict (tighten) to prevent blood loss and platelets (special clotting cells) gather to build a clot.A wound may fail to heal if one or more of the healing stages are interrupted. The healing processThe healing process of a skin wound follows a predictable pattern. Trophic ulcers, where a lack of sensation allows everyday trauma to lead to an ulcer – such as in diabetic neuropathy and leprosy.Specific types of infection such as the Bairnsdale or Buruli ulcers ( Mycobacterium ulcerans).Underlying medical conditions such as diabetes or some types of vascular disease.
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