What can delay or expedite wound healing

Our body is covered by an elastic skin that can be damaged or torn. The body has an automatic mechanism of repair for the damage.Due to human beings’ close interactions with the surroundings; it is very difficult to avoid contact with sharp objects that damage our skin. However, the rate of body reparation varies from one individual to another depending on the severity of the injury.There are several factors that could lead to delayed healing of a wound under normal circumstances. One of the most noticeable factors is age among many others. Young people and old people have different healing rates based on their collagen muscle fibres and the physiology of their body.The physiological changes that occur in old people make their injured body weaker than in young individuals. In old people, there is reduced skin elasticity as well as collagen replacement. This physiological condition can also lead to delayed wound healing process.Obese people also experience a compromise in wound healing especially due to poor blood supply to the skin and its components. Protein deficiency in many obese people usually delays wound repair.In most cases, old people tend to have inadequate nutritional intake as compared to young people, altered hormonal responses that comes with age, poor hydration as many old people do not re-hydrate regularly among other factors.This is why people have recurrent wound infections poorly healed wounds should get blood check-up and not by physical appearance. Parameters such as albumin levels, total lymphocyte count, and transferring levels are always markers for body nutrition deficiency that must be assessed and monitored regularly. Low levels of these markers are seen in people with protein deficiency, protein is needed for cell growth.For people with marked or visible malnutrition, you also need to measure the hemoglobin level as it helps to assess the oxygen-carrying capacity of the blood. Iron level is also assessed as it is required for transport of oxygen. There are many other nutrients required by the body for proper healing. For example protein is required for all the phases of wound healing, particularly important for collagen synthesis. Glucose balance is crucial for proper wound repair.Minerals such as zinc and copper are important for enzyme systems and immune systems. Zinc deficiency contributes to disruption of granulation tissue formation. This delays the healing process.Vitamins A, B complex and C are responsible for supporting epithelialization and collagen formation. This helps to overcome the inflammatory phase of the wound healing.Carbohydrates and fats provide the energy required for cell function. This also facilitates wound healing.Additionally, People with chronic illnesses also tend to suffer delayed wound healing. Diseases like chronic cardiac insufficiency as seen in coronary heart disease, cancer, diabetes mellitus among others compromise with wound healing.Factors that reduce immune system of the body such as medications affects wound healing. For example cytotoxic and, immunosuppressive drugs used for cancer treatment and anticoagulant drugs all reduce healing rates by interrupting the clotting process of the wound site.Hygiene is one of the key conditions that influence wound healing. With good hygiene, it is very easy to control problems such as infection, increased trauma and pressure among others.Effective hand washing greatly reduces the risk of transferring pathogenic organisms from one person to another by direct contact or even contamination of objects shared.One of the common problems linked with poor hygiene is wound infection or colonisation of micro-organisms. In infection, there will be deposition and multiplication of these micro-organisms. If the reaction to the tissue of the host is minimal then it is wound colonisation rather than infection. The wound should be kept in a moist environment that allows wounds to heal faster and less painful. Under dry environment, cells dehydrate and die. There is formation of a scab or crust over the wound site that impedes proper healing. This is also the reason why in health set-ups; the wound is kept hydrated with a moist and retentive dressing to enhance epidermal cell migration that facilitates epithelialization. Dr.Joseph Kamugisha is a resident oncologist based in Jerusalem, Israel