Slow wound healing: what are its causes (+ risk factors)

Slow wound healing can be caused, for example, by the severity or depth of the wound. The deeper the wound, the greater the extent of the wound, the longer the healing time.

Sometimes, however, the healing time is unnaturally long and may be caused by a health problem in the body. It may be a lack of vitamin C, which makes new tissue form in the original wound. But it may also be caused by more serious diseases of the blood, skin or immune system that require treatment.

Risk factors play a role in wound healing. These are:

• Age, wounds heal less well at older ages
• smoking
• reduced immunity
• vascular disease
• diabetes
• malnutrition
• liver disease
• chronic renal failure
• arthritis

Slowed healing caused by wound infection

If a wound becomes infected after an injury, there may be a slowing of healing. When a wound becomes infected, redness, swelling, soreness is present. Alternatively, suppuration of the site is present and becomes inflamed.

Most often, the wound site becomes infected with bacteria. Subsequently, local treatment is chosen, which includes disinfection and cleaning of the wound. Alternatively, general antibiotics are administered.

As a consequence of the stress on the wound site

In some cases, a wound develops in a place where the skin is overstressed. This subsequently slows down the healing process. Therefore, it is important to keep the wound site still during wound healing. This is the case, for example, with skin injuries in the knuckle area, but also in the palm of the hand.

Disorders that cause poor wound healing

It is a serious problem if the healing process results in reduced blood supply to the site. This in turn causes a lack of nutrients and oxygen. Reduced blood supply (technically also hypoperfusion) can be the result of vasoconstriction, shock, but also occurs in atherosclerosis or thrombosis.

Reduced blood flow and damage to blood vessels also occurs in diabetes. In addition to reduced blood flow, anaemia also has a negative effect. Infections are common in anaemia and slow wound healing also occurs.

Overall, it is important for healing that the body has sufficient nutrients to provide the building material to repair the wound. Healing is slowed down in the case of nutrient deficiencies, which occur with malnutrition and other nutritional disorders.

This is especially the case with reduced levels of protein and vitamin C, B vitamins, folic acid (B9), vitamin A. Among the trace elements, zinc, iron and silicon are needed. A balanced diet is important, even outside the healing period.

Very often there may be a bleeding disorder, also called haemophilia, which is a congenital disease that is only fully manifested in men.

A defective gene is present in the X chromosome. This leads to a deficiency in the production of one of the plasma proteins involved in blood clotting at the site of injury. A deficiency in this protein causes slower or insufficient blood clotting.

Some people also suffer from a condition called increased bleeding, which is a blood disorder caused by a disorder of haemostasis. Haemostasis (note, not homeostasis) is the mechanism that ensures that bleeding stops after an injury that has occurred due to a breach in the blood vessel wall.

The most common symptom of this disease is increased bleeding even with seemingly small cuts or puncture wounds, frequent bruising (haematomas), but also very slow healing of such wounds. The person may also experience increased fatigue.

Healing is also slower in the elderly, who have a poor vascular supply to the tissues. As part of the healing process, immediately after the wound has formed, a blood clot forms at the site of the injury. This clot later dissolves and there is an accumulation of functional cells at the site of the injury.

However, some diseases cause a deficiency of these cells and also a deficiency of immune cells that should prevent infections from forming at the site of injury. Infections also slow down wound healing. Such a deficiency of functional cells is also present in leukaemia.

Leukaemia is a disease of the blood, which is also called blood cancer. Very often, it is also manifested by increased bleeding, for example during injury. In addition, other cancers also have a negative effect.

In people with AIDS, the immune system is damaged. If there is an external injury and a wound, very often an infection gets into the wound just from the lack of immune cells and the lack of white blood cells. People with this disease also suffer from slow wound healing and blood problems.

Diabetes is also a cause

People with diabetes also have problems with slow wound healing. Increased blood sugar levels result in damage to nerves, blood vessels, in addition to kidneys, retinas, even, lowering immunity.

The interplay of these circumstances is also responsible for poor wound healing and increased risk of infection. In addition, symptoms such as:

• muscle weakness
• loss of muscle mass
• muscle cramps
• impaired mobility
• tingling, tingling, burning (paresthesia)
• itching
• dry skin
• redness of the skin
• cold extremities
• numbness or perception of unreal pain