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Wounds That Won’t Heal

Posted: April 1, 2007

Any wound that does not show improvement in four weeks or is not totally healed in eight weeks is considered a chronic, non-healing wound. Approximately six million people in the United States suffer from chronic, non-healing wounds, and this number is growing steadily.

Patients over age 65 are the most frequent chronic wound sufferers. People with diabetes, venous insufficiency and pressure ulcers are among those who most frequently develop chronic wounds. The ability of wounds to heal properly is determined by adequate blood supply, proper wound care techniques and control of coexisting medical problems.

The body has a natural ability to heal wounds; however, there are specific cells that must travel to the wound area for them to be effective. In order for cells to be transported to the area of the wound, an intact blood supply must exist. If there are blockages in the arteries (atherosclerosis), the transport of these cells and antibiotics cannot reach the wound and wound healing is impeded.

Arteries bring blood to the wound and veins carry it away. Problems with veins can prevent toxins and other products from being carried away from the wound. Also, vein problems can cause leg swelling (edema), which is a deterrent to wound healing.

Diabetes and other health problems
Medical problems (diabetes, heart failure, and immunosuppression) can adversely affect the ability of a wound to heal. Diabetes mellitus has long been recognized as a major impediment to wound healing. Since many wounds carry with them an infection—infections tend to impair the control of blood sugar—a vicious cycle is begun that can produce dramatic problems of limb-threatening infections. It is of utmost importance that glucose levels in those with diabetes be well controlled, most especially during a time when one is attempting to heal a wound.

Patients who suffer from heart failure also represent a difficult problem in wound healing. The primary problem in these cases is related to the leg swelling (edema) that develops as a result of the heart failure. Leg edema makes wound healing extremely difficult and allows infection to develop and spread readily.

Immunosuppression due to acquired diseases or a result of medications also contributes to wound healing problems.


Source: National Heart, Lung and Blood Institute

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