Delayed Wound Healing: Causes and Solutions

Wound healing issues

Hello Dr.
Lee, in mid-February of this year, I sustained a deep laceration on the skin over the anterior tibia of my lower leg (almost to the bone) from a motorcycle side stand.
I promptly went to the hospital for debridement and suturing.
Two weeks after the stitches were removed, I noticed poor healing for some unknown reason, and the deepest part of the wound reopened.
However, it was not sutured again; instead, the wound was cleaned and secured with cosmetic adhesive.
The wound healed around late April, but now my scar continues to develop small abrasions, and there is no sensation around the scar (pressing the surrounding area feels similar to when a foot is numb; I can tell something is touching it, but I can't feel it well).
If I make larger movements, I also experience pain.
Given that so much time has passed, is this considered normal, or should I seek further medical attention? I am concerned that the wound may not have been cleaned properly during the initial suturing when it reopened.
Thank you, Dr.
Lee.

yt, 20~29 year old female. Ask Date: 2021/08/04

Dr. Li Zhonghuai reply Surgery

Hello! This wound is difficult to heal.
If there are no secretions after healing, we will monitor it conservatively.
Taking vitamin B12 can promote nerve repair.
Take care! Changhua Hospital cares about you!

Reply Date: 2021/08/04

More Info

Delayed wound healing can be a frustrating and concerning issue, especially after a significant injury like the one you described. When a wound does not heal properly, it can lead to complications such as infection, scarring, and chronic pain. Understanding the potential causes and solutions for delayed wound healing is essential for managing your situation effectively.

Causes of Delayed Wound Healing
1. Infection: One of the most common reasons for delayed healing is infection. If bacteria enter the wound, they can cause inflammation and tissue damage, which can impede the healing process. Signs of infection include increased redness, swelling, warmth, and discharge from the wound.

2. Poor Blood Supply: Adequate blood flow is crucial for wound healing as it delivers oxygen and nutrients to the damaged tissue. Conditions such as diabetes, peripheral artery disease, or other circulatory issues can significantly reduce blood flow to the area, leading to slower healing.

3. Nutritional Deficiencies: Proper nutrition plays a vital role in wound healing. Deficiencies in essential nutrients such as protein, vitamin C, zinc, and vitamin A can impair the body’s ability to repair tissue.

4. Underlying Health Conditions: Chronic conditions like diabetes, autoimmune diseases, or obesity can affect the body’s healing response. These conditions may alter the inflammatory response or the body’s ability to regenerate tissue.

5. Mechanical Stress: If the wound is subjected to excessive movement or pressure, it may reopen or heal poorly. This is particularly relevant in areas of the body that experience a lot of motion or friction.

6. Age: As people age, their skin becomes thinner and less elastic, and the healing process slows down. Older adults may also have underlying health issues that can affect healing.

Solutions and Recommendations
1. Consult a Healthcare Professional: Since you are experiencing ongoing issues with your wound, it is advisable to consult a healthcare provider. They can assess the wound for signs of infection or other complications and recommend appropriate treatment.

2. Wound Care: Proper wound care is crucial. Keep the area clean and dry, and follow your doctor’s instructions regarding dressing changes. If you notice any signs of infection, such as increased redness, swelling, or discharge, seek medical attention promptly.

3. Nutritional Support: Ensure you are consuming a balanced diet rich in vitamins and minerals that support healing. Consider consulting a nutritionist if you suspect dietary deficiencies.

4. Avoid Stress on the Wound: Try to minimize movement or pressure on the affected area. If possible, use protective padding or dressings to shield the wound from friction.

5. Follow-Up Care: Regular follow-up appointments with your healthcare provider can help monitor the healing process and address any concerns that arise. If the wound continues to reopen or if you experience chronic pain, further evaluation may be necessary.

6. Physical Therapy: If you are experiencing pain or limited mobility due to the injury, physical therapy may help strengthen the surrounding muscles and improve function.

7. Scar Management: If you are concerned about scarring, discuss options with your doctor. Treatments such as silicone gel sheets, pressure garments, or laser therapy may help improve the appearance of scars.

Conclusion
In summary, delayed wound healing can result from various factors, including infection, poor blood supply, nutritional deficiencies, and mechanical stress. Given your ongoing symptoms, it is essential to seek medical advice to ensure proper management of your wound. With appropriate care and attention, many wounds can heal effectively, and any complications can be addressed promptly. Remember that healing is a process, and it is important to be patient while following your healthcare provider's recommendations.

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