Risk factors for impaired wound healing
Wound complications can present in many different forms. One thing is certain: the healthier the wound tissue and the peri-wound skin, the greater the chances of healing. Patients may already have pre-disposing risk factors that delay wound healing, however infection, biofilm and poor wound management can further contribute to the chronicity by further delaying wound healing.
Risk factors linked to a pathology
Venous insufficiency is when the deoxygenated blood and waste products are not ejected back up the venous system within the body. As a result, this causes prolonged pressure in the veins which, if not, treated causes oedema and skin changes.
Diabetes unbalances blood sugar levels, alters the arteries and nerves, especially in the foot, making certain injuries (even small ones) imperceptible.
Arterial insufficiency prevents the wound from receiving enough arterial blood to heal.
Malnutrition deprives the body from essential nutrients that the skin needs to repair itself.
Risk factors linked to lifestyle habits
Smoking can damage the arteries and ultimately prevent sufficient oxygenation of the wound.
Wearing unsuitable shoes can interfere with blood circulation, put pressure on an existing wound or cause friction that is harmful to the skin.
Failure to respect basic hygiene rules such as washing daily, drying well down to the toes after washing, cutting nails properly ...
Sedentary lifestyle increases the risk of cardiovascular disease and diabetes. A minimum of physical activity is therefore recommended to ensure a balanced metabolism.
Risk factors linked to the patient profile
Age, with aging, the skin becomes thinner, which further increases the fragility of the tissues. The elderly are also more prone to dry skin, their skin being less hydrated than younger skin. Finally, its lack of elasticity slows down the healing process.
Psychological state, stress and depression are common in patients with wounds that can take a long time to heal. Managing these factors - whether they relate to pain, the length of time to heal, painful treatment, or a more generalized feeling of anxiety - is key to healing.
DID YOU KNOW? Fibroblast - the key cells to wound healing!
Fibroblasts are essentials cells for wound healing. During skin repair, fibroblasts migrate within the wound area, proliferate and synthesise the extracellular matrix to form the granulation tissue⁽¹⁾.
Fibroblasts are then differentiated in situ into myofibroblasts, which, due to their contactlile properties, bring the edges of the zound together⁽¹⁾.
1. Bainbridge P, Wound healing and the role of fibroblasts. Journal of Wound Care. 2013 Aug;22(8):407-8,410-12.