The human body is amazing in its ability to heal and protect itself from the outside world. Every day more research is released proving the magnificent chain of events, that occur at the cellular level, allowing injuries and wounds to fill in (granulate) and close. Understanding the cellular communication and what is needed to support self-healing gives wound care specialists the ability to determine what is preventing a wound from following a normal course of closure.
All wounds or injuries follow a four-stage healing process: hemostasis, inflammation, proliferation, and remodeling. When the body moves through this process successfully, you should see the wound progress from a bleeding open wound to a pink and slightly warm sore filling in then scabbing, which leads to a scar that, over time, softens and blends into the surrounding tissue. This process will happen over a few weeks to a month and the healthy change in the wound can easily be seen.
What Happens When a Wound Fails to Follow the Normal Healing Process?
There are a multitude of chemical reactions and signaling occurring at the cellular level and because these processes depend on a variety of host factors (the body for instance), it becomes a Sherlock Holmes style case to uncover what’s impeding the healing process. This is when the need for a wound care specialist comes into play.
The wound care specialist will take a holistic approach to determine why a wound is not following the normal progression of healing. A simple overview approach can be described by assessing and addressing the six factors that contribute to the overall wound healing process.
Oxygenation
This is the process of evaluating if the wound bed is receiving enough oxygen to support normal cellular functions. This includes understanding the heart, venous and arterial health of the patient and providing guidance and intervention to remedy any problems with blood flow.
Nutrition
Here we evaluate if the patient has had enough of the right food groups, vitamins, and minerals to support tissue growth. Nutrition can be assessed through laboratory tests and food logs. Changes in dietary habits and sometimes nutritional supplementation can help move a wound toward closure.
Infection/Necrotic (dead) Tissue
Understanding if the body is currently fighting an infection as it’s trying to heal a wound is crucial to the healing progress. By determining if there is bacterial burden at the wound bed and treating it accordingly, the healthy cells can get back to signaling and orchestrating the healing sequence. Removal of any dead tissue by the wound care specialist and preserving the healthy cells in the wound bed reduces the opportunity for bacteria to thrive.
Injury
Is the wound continually being agitated by pressure, friction, or shear? By assessing any external forces that might impede healing and providing proper protection and offloading with specialty mattresses, shoes, total contact casting and wheelchair cushions, this variable can be managed.
Illness and Disease
Here is where we evaluate if the patient is fighting an existing illness such as pneumonia or anemia or if other ailments like diabetes, congestive heart failure or autoimmune diseases that would impact the body’s ability to focus on healing. Managing these co-morbidities can be more complicated and requires an in-depth collaborative approach among providers to optimize the body’s natural abilities.
Medication and Lifestyle
Patients taking prescription medication or over-the-counter supplements could be affecting their wound healing process. Because medications are typically used to change and regulate a specific cell function, understanding how these might affect wound healing is important. Also, the patient and the wound care specialist will work together to understand the affect any lifestyle habits, such as smoking, might have on the healing process and will work to address these in a holistic manner.
How Will a Wound Care Specialist Treat a Non-Healing Wound?
The wound care specialist is an expert in understanding the normal processes of wound healing. Through very specific detective work, they can determine the barriers of healing and address these barriers through a whole-body approach. This is considered the assessment and diagnosis phase for a holistic approach to a patient’s healing process.
The wound care specialist possesses expert knowledge in the most current advanced treatment options available and when to initiate those treatments. Negative Pressure Wound Therapy, biologics and hyperbaric oxygen therapy are some of the advanced treatment tools the wound care specialist can prescribe. Utilizing these advanced treatments in the proper sequence and close monitoring of the body’s response allows the wound care specialist to provide an individual treatment plan.
Why it's Important to Seek Professional Help
Remember, the human body is designed to orchestrate a very detailed and specific sequence of events to heal, keeping the environment out and protecting what’s inside. When this doesn’t occur naturally the wound care specialist is professionally trained to identify and treat these issues.
Living with a non-healing wound can be painful, expensive, depressing and dangerous. Wounds that are not managed correctly can lead to additional risks associated with chronic wounds. These risks include infection, bone involvement, reduced mobility and unfortunately can lead to preventable amputations. Utilizing a wound care specialist to “crack the case” greatly increases the probability of a positive healing outcome and a return to normal life.
To be connected with a wound care specialist for your wound care needs, complete our request form or reach out to the Cork Medical team at 866.551.2580.