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Most people have
no problems healing, but the process can be a nightmare
for some people. Below is a list of the primary
reasons a wound isn't healing or is healing far too
slow.
1) The most
common reason for delayed wound healing is poor
nutritional habits or poor general health.
- Eat right and take vitamins. No Fast Food!
- RELAX! It has been proven that stress impairs
your immune system and slows down healing.
- CHILL OUT! Research has shown that anger slows
healing. Those who control their anger heal faster
than those who have a short boiling point.
- Avoid using antibiotic ointments (Neosporin,
Bacitricin, etc.) These are proven to
frequently cause allergic reactions and contact
dermatis with regular use.
- Try doing sitz baths with Epson Salts in the
water.
- Make sure you are getting at least 60 grams of
high quality protein daily.
- Breathe. Deeply and slowly. Healing uses a lot
of oxygen from the bloodstream. Try an exercise of
doing 5 minutes of deep breathing, three times a
day.
- Get some oxygen into the wound by spending 15
minutes, twice a day with the wound fully exposed to
air (spread those cheeks apart if you have to!)
- Make sure you are changing your packing at least
twice daily.
- Try some of the newest dressings and ointments to
speed healing.
2) The second thing to look at is infection.
- Is the wound inflamed, painful, or draining a
bad smelling fluid? See a doctor ASAP, especially
if you are running any kind of fever.
- It could be hair or debris getting into the wound and
causing irritation.
- It could be that a sinus or a section of the
cyst was missed during surgery.
- Any surgical wound infection is serious
business. If you think for one minute that you might
have an infection, get to the doctor ASAP. Left
untreated, wound infections can turn into Sepsis
(infection moves into the blood) which will require
hospitalization and can be fatal.
3) Do you possibly have undetected diabetes
or an immune system disorder?
- One of
the symptoms is slow healing wounds.
4) Closed Incisions:
- Closed incisions are infamous for infections.
Once the swelling starts to go down by day 4 or 5,
keep a close watch on the incision for redness, pain
and discharge. See above notes on surgical wound
infection....
- Closed incisions can also fail to mend and the
wound can completely break down. If this happens,
you need a highly skilled team of people treating
you. A Wound Care Specialist is a must! Do not
ask your doctor to go this one on his/her own, no
matter how great or competent they are.
- It is not at all uncommon to have a small
section at the bottom of the incision fail to heal,
usually it is because this section gets less oxygen
due to location. Advanced care products such as
Multidex Powder can help.
5) Wound Healing Centers: Once you have
ruled out the above possibilities, it is time for a
Wound Care
Center. Most major cities have one, just check the phone
book or call the hospital to ask. Wound Care Specialists
are the SWAT team of healing, all they do is treat
wounds and they are far more knowledgeable than your
surgeon. Your surgeon has gone through extensive
training in cutting and sewing, a Wound Care Specialist
has gone through extensive training in wounds.
Surgeons frequently are not the best at things like
aftercare and wound healing, which is why we recommend
that if it has taken longer than 4 months to heal your
wound, it's time to bring in the professionals...
6) Other things that
can go wrong: These are fairly rare occurrences, but
they do happen.
- Hematomas
- a pocket of blood, or clot, in the wound.
More likely to happen in closed wound incisions.
These need to be opened up to drain or removed since
they can become infected.
- Seromas -
this is an accumulation of fluid in the "dead space"
of the surgical wound. Unlike an abscess, this
is not an infection, just a pooling of fluid.
More likely to happen in closed wound incisions or
in an open wound that has closed over at the top too
quickly, leaving "dead space" open underneath. Some
of these may resolve themselves, but most need to
have the fluid drained and the "dead space" needs to
be closed, either by deep suturing or by re-opening
the top of the wound and packing until it heals from
the bottom up.
- Wound
Breakdown (dehiscence) - this is a softening of the
wound tissues that can happen in the deep layers or
the top skin layers. In a closed incision,
this means that the sutures can't hold and the
patient needs to resort to open healing.
Consider a Wound VAC:
Vacuum-assisted closure (VAC) is a non-invasive
technique whereby negative pressure is delivered in a
uniform manner to a wound. This encourages the
arterioles to dilate, so improving blood flow, promoting
a moist environment and assisting in the proliferation
of granulation tissue. A foam dressing is cut to the
shape of the wound and then applied over the wound.
Suction tubing is inserted into the foam dressing and
the foam and suction tubing covered with an occlusive
film dressing, prior to connecting the tubing to the
suction pump. The negative pressure can be either
continuous or intermittent, and can be administered at
between 50 mmHg to 200 mmHg depending on patient comfort
(Baxandall, 1996). The use of the VAC system has
resulted in progressive wound closure in cavity wounds,
and is now often used on patients in the community as
well as in the hospital setting.
Read
Cathy's experience with a Wound VAC
More info on
VAC
Vacuume Assisted Closure
(pdf) World Wide Wounds 2001
www.kci1.com/products/VAC/index.asp
This page last updated:
06/25/2008
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