Slow Wound Healing

What Causes Poor Wound Healing?

Poor wound healing can have various causes, ranging in severity from 'minor' to 'life-threatening'.  Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.

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Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms.  In order to diagnose poor wound healing, we could:

  • Research the topic
  • Find a doctor with the time
  • Use a diagnostic computer system.
The process is the same, whichever method is used.

Step 1: List all Possible Causes

We begin by identifying the disease conditions which have "poor wound healing" as a symptom.  Here are eight of many possibilities (more below):
  • Stress
  • Chemotherapy Side-Effects
  • Cigarette Smoke Damage
  • EFA Need
  • Need For Dietary Improvement
  • A Weight Problem
  • Nutritional Deficiency
  • Drug Side-Effects

Step 2: Build a Symptom Checklist

We then identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
an average-stress lifestyle
dizziness when standing up
low fruit/vegetable consumption
secondhand smoke exposure
constant bowel movement changes
tonsils/adenoids out before age 20
poor mental clarity
high alcohol consumption
thin cracked heel calluses
eating during sleep hours
frequent bizarre dreams
somewhat disturbed sleep
... and more than 100 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of poor wound healing:
Cause Probability Status
A Weight Problem 97% Confirm
Drug Side-Effects 26% Unlikely
Need For Dietary Improvement 24% Unlikely
Stress 2% Ruled out
Nutritional Deficiency 2% Ruled out
Cigarette Smoke Damage 2% Ruled out
Chemotherapy Side-Effects 0% Ruled out
EFA Need 0% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

In the Immune System Symptoms section of the questionnaire, The Analyst™ will ask the following question about slow wound healing:
Wound healing. Do your wounds (any breaks in the skin) seem to take longer to heal than they would in other people? Small wounds normally take 3 days to 3 weeks to heal (grow new skin over the injury).
Possible responses:
→ No / wounds heal quickly / don't know
→ Moderately - healing takes longer than it should
→ Severely - healing takes months (or even years)
Based on your response to this question, which may indicate either slow-healing wounds or very slow-healing wounds, The Analyst™ will consider possibilities such as:
(Prescription) Drug Side-Effects

Many medications inhibit wound healing.  Examples include drugs that interfere with clot formation, platelet function, inflammatory responses, or cell proliferation; certain steroids, NSAIDs, chemotherapy drugs.

Alcohol-related Problems

Alcohol impairs wound healing and increases the likelihood of wound infection.  Alcohol impairs the early inflammatory response; it inhibits wound closure, development of new blood vessels, and collagen production; it alters the protease balance at the wound site, which is needed to remove foreign matter and dead tissue; it decreases resistance to infectious microorganisms.

Chemotherapy Side-Effects

Most chemotherapy drugs inhibit cell functions that are critical to proper wound repair.

Cigarette Smoke Damage

Smoking delays wound healing by weakening the immune system and reducing oxygen levels.

Consequences of Poor Diet

A well-balanced diet provides the body with the tools (nutrients) it needs to repair wounds.

Diabetes Type II

People with diabetes often have impaired wound healing.  Even a tiny sore may remain unhealed and/or infected for months or even years.  In severe cases, overwhelming infection and lack of oxygen and nutrients leads to gangrene.

EFA (Essential Fatty Acid) Requirement

Failure to provide either omega-6 or omega-3 fatty acids in the diet results in poor wound healing.

Low HGH (Human Growth Hormone)

Human growth hormone (HGH) levels decline with age.  HGH stimulates the production of collagen, which sticks wounds together, strengthens weakened tissue, gives skin more elasticity and helps wounds of the skin or bone heal faster and stronger.

Problems Caused By Being Overweight

Obese individuals often experience delayed wound healing due to a number of factors including: reduced oxygen, nutrient and blood supply to the wound site; moisture and microorganism collection in skin folds that decreases skin integrity and increases risk of infection; immobility, skin friction and skin shear impair the skin's barrier function.

Stress

Studies have shown that stressed individuals often exhibit significantly delayed wound healing.

Zinc Requirement

Many studies have demonstrated enhanced wound and ulcer healing with oral zinc supplementation.  The healing time of surgical wounds was reduced by 43% with zinc sulfate at 50mg tid.  Not surprisingly, zinc deficiency is also associated with impaired wound healing.  A study of patients deficient in zinc found that topically applied zinc oxide, but not zinc sulfate, enhanced the regeneration of epithelial tissue on leg ulcers.  In addition, inflammation and bacterial growth were both reduced.

1. What is the use of zinc for wound healing?  Int J Dermatol 1978;17: pp.568-70
2. Acceleration of healing with zinc sulfate.  Ann Surg 1967;165: pp.432-6
3. Studies on zinc in wound healing.  Acta Derm Venereol Suppl 1990;154: pp.1-36

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