6 Reasons Why Your Wound Won't Heal

Contrary to popular belief, time doesn’t necessarily heal all wounds.

According to Jennifer Heller, M.D., medical director of GBMC’s Wound Center, the body usually goes through three basic stages of healing after suffering a wound.

“During the inflammatory phase, the body sends white blood cells to fight the injury and launch the healing process,” Dr. Heller says. “Healing continues during the proliferative phase, which eventually leads to the remodeling phase where the scab has disappeared and new skin has formed over the wound site.”

If you’ve got a wound that seems to be taking longer than normal to heal, here are a few possible reasons why:

You’re a smoker.

Because smoking narrows blood vessels, it restricts oxygen delivery to the wound, slowing healing at the cellular level and increasing your chances of infection

Underlying medical conditions.

Health conditions like diabetes, arterial disease, lupus, renal failure and others can compromise your immune system and prolong the healing process.

Medications.

Medications that are required to treat some illnesses (steroids and blood thinners, for instance) may hinder your body’s ability to repair itself.

Poor nutrition.

“Good nutrition is a vastly underestimated factor in wound healing,” Dr. Heller says. “We stress this with our patients all the time. Protein is an especially important healing component.” She encourages patients to consider a liquid protein supplement. There are also supplements specialized for patients who are on diabetic diets. Multivitamins and other nutritional supplements are often recommended.

Poor circulation.

Normal blood circulation is very important for wound healing.
“Anytime someone comes to us with a leg wound, we assess their circulation through a physical exam and ultrasound,” Dr. Heller says. “Depending on the characteristics, location and other factors, we can get a pretty good idea of whether the wound is due to poor blood supply, other factors or a combination. Sometimes we have to take measures to correct the arterial or venous circulation before treatment can proceed.”

Overweight or obesity.

Excess weight can cause chronic swelling in the legs that prevents wounds from healing effectively.
“Sedentary patients, paraplegics and the elderly can develop pressure ulcers, particularly in the sacral area,” Dr. Heller says. “We take a proactive approach with people from assisted-living facilities to try to prevent these wounds before they occur.”
Don’t hesitate to see your doctor if you have a wound that won’t heal.
“With most wounds, you should start to see some improvement within a few days,” Dr. Heller says. “It never hurts to have it examined. If you come in right away, we can treat the wound before it turns into a major problem. At the very least, we can reassure you that it’s healing the way it should.”
Over-the-counter ointments and triple-antibiotic creams may offer some benefit for minor injuries like skinned knees and superficial scrapes but shouldn't replace medical treatment in cases of serious or penetrating injuries. It’s always important to watch for signs of infection and seek treatment immediately if you notice fever, a foul odor, drainage, redness or soreness at the wound site.
“How quickly your wound heals really depends on your overall health,” Dr. Heller says. “There are steps patients can take to minimize risk factors that prolong the healing process, such as smoking cessation, diabetes management, making sure you follow a healthy diet and exercising on a regular basis.”
The Wound Center at GBMC is a multidisciplinary physician group that offers comprehensive wound care treatment including pain management, surgery, education and counseling.