When dealing with advanced wounds there are many things that can stall the healing process, making them quite different from traditional wounds. Understanding what these things are, and knowing how to best prevent them, is the first step in insuring your healing stays on schedule.
Avoiding and Treating Infection
Infections can be easily controlled and treated when caught early enough, but can require hospitalization or even amputation if left to become a severe infection. If you suspect your wound is infected, make sure to see your doctor right away.
Symptoms of infection that you can look out for include:
- Increased redness around the wound
- Heat at or surrounding the wound
- Sudden growth of the wound
- Increased pain and/or swelling
- You begin to experience fever or chills
- The wound gives off an unpleasant smell
- The wound has increased drainage (pus or cloudy fluid)
You can try to avoid infection by cleaning the wound well through every stage of healing, as well as taking any medication that has been prescribed to you. Make sure to properly clean and sanitize your hands before changing any dressing, as well as making sure that any and all wound care supplies remain sterile too.
If your wound becomes infected, doctors may give you antibiotics as treatment, and your wound healing will be back on schedule.
Prevention of Biofilm Formation
Biofilm is a microbial community made up of cells which attach themselves to a surface. When that surface is your wound, the biofilm cells prevent the body’s cells from continuing their healing process. This can either slow down the healing or cause it to stop completely.
The cells in biofilm can become tolerant and resistant to antibiotics and immune responses, making prevention important.
To prevent biofilm from building to a point that stalls healing, your doctor may give you a non-cytotoxic agent to clean the wound with. Ensure you are vigilant about cleaning, and inform your doctor if you become concerned about the time it is taking for your wound to heal. They can see if your wound has developed a biofilm and will guide you through treatment to remove it.
Epiboles are rolled or curled under edges of a wound, which may by dry, callused, or hyperkeratotic (a thickening of the outer layer of skin). These edges form a ‘wall’ that stops other cells from migrating across the wound and continuing healing. Removal may be necessary if granulation tissue has filled the wound, and the rolled edge is the last thing that needs healing. But, the rolled edge is not infectious and won’t spread, so removal is not an urgent matter. Doctor’s will often wait for the wound to be more filled-in before suggesting removal, especially if the wound is deep or if you don’t have many tissue stores.
You can wrap the wound with dressings that help promote epibole healing. After a certain time, doctors will physically remove the epibole with the appropriate equipment if the dressings haven’t worked enough, or if the wound has stopped showing any improvement.
Removal of Non-Viable Tissue
If left in the wound, non-viable (necrotic) tissue creates the ideal environment for bacterial growth and infection, while also preventing new tissue from developing in its place. Viable tissue, which is able to conduct regular wound healing, will be red or pink. Non-viable tissue can be black, brown, or yellow, and needs to be removed. Cleaning out and removal of non-viable tissue is known as debridement. Debridement can be done through various methods, including:
physical removal of necrotic tissue using a scalpel or surgical scissors
includes irrigation, hydrotherapy, and wet-to-dry dressings
involves hydrocolloids and hydrogels which add moisture to the area, aiding your body in dissolving the necrotic tissue itself
a topical agent which contains enzymes to dissolve and consume necrotic tissue
Keeping your wound as clean and sanitary as possible is an important aspect to ensure your healing stays on schedule.
If you are unsure or concerned about how your wound healing is progressing, contact an advanced wound care specialist, who can provide you with other treatment options if necessary, along with expert medical advice.