Wound care after injury is an essential thing for preventing wound infection and complications in the wound so, knowing how to care for the wound either using antibiotic ointment or other therapeutics or daily cleaning of it is important for every wound.

More than one factor interferes with one or more phases thus causing impaired or improper wound healing. In this article on significant factors that affect cutaneous wound healing.

The factors discussed include oxygenation, infection, age and sex hormones, stress, diabetes, medical care, alcoholism, and nutrition. A better understanding of these factors on repair may lead to therapeutics that improve wound healing and improve impaired wounds.

What is wound healing?

Wound healing is a normal process in the body of humans and occurs in four programmed phases: hemostasis, inflammation, proliferation, and remodeling.

For a wound to successfully heal, all four phases should occur in the proper phases and time.

What are the stages of open wound healing?

An open wound is healed when it goes through all stages of healing, which are represented in the following:

1. The stage of stopping bleeding and clotting:

Within a few seconds or even minutes after the injury, the blood vessels around the wound begin to narrow, and platelets begin to collect and clot at the site of the wound until the wound closes completely and the bleeding stops.

Over time, these clots in the wound area turn into hard crusts that contain special materials to help them attach to the wound until the tissues or cells below it recover. 

2. Inflammatory stage:

After the wound closes completely and the bleeding stops, the blood vessels in the area return and open; To provide the area of injury with nutrients and oxygen needed for the healing process.

In the meantime, white blood cells work to protect the wound from infection and from any external contaminants, which is a very important stage that determines when the open wound will heal.

All this may cause:

1. Redness.
2. Swelling in the wound area.

Clear liquid coming out indicates that white blood cells are cleaning the wound site.

3. The stage of cell renewal and tissue recovery:

The stage of cell renewal and tissue recovery is the penultimate stage of wound healing, where orders from the brain at this stage reach the wound area to urge cells to start manufacturing collagen and new skin tissue, and here a scar begins to appear.

The scar is initially red, then gradually turns to a lighter color close to the color of the skin, and sometimes the scar disappears completely after the wound heals.

4. Maturation stage:

At this stage, although the wound may appear to be completely closed, the body is still in the process of recovery, So the patient may feel a kind of itching or tightening in the wound area, as new tissues are still in the process of growth, and these symptoms disappear with Complete healing and healing of the open wound.

What are the signs of non-healing wounds?

The answer to the question when does an open wound heal? However, it remains to identify some signs that may mean a defect in the healing process of the wound:

1. Pus and pus coming out of the wound area. 
2. An unpleasant smell comes out at the wound site. 
3. Feeling of fever. 
4. Feeling of increasing pain at the site of the wound. 
5. Feeling a kind of warmth, softness, and redness in the wound area, none of which subsides with time.
6. Gradual darkening of the skin at the site of the injury. 

What are the different types of wounds?

1. Leaking Wounds: Wounds that are prone to fluid secretion and that need to be dried using a non-isolating product that allows air to reach the wound such as:
2. Nappy rash.
3. Fluid between skin folds.
4. Chickenpox with its secretions.
5. cutaneous bubbles.
6. Non-oozing wounds: They are superficial to medium wounds that need moisture from a breathable semi-isolating product such as:
7. After surgery (e.g., stitches).
8. Cuts, scrapes, and other daily injuries after the wound has dried.
9. Chickenpox in the recovery stage. 
10. After cosmetic procedures eg, peeling, and laser treatment. 
11. permanent hair removal, tattooing, and tattoo removal. 
12. Non-leaking nappy rash. 
13. Radiation therapy. 
14. Non-Operating Wounds: Medium to major wounds that require nourishment and replenish lipids from a barrier product that forms a barrier on the surface of the skin such as: 
15. Cracks, dry spots, pulpitis, etc. 
16. Burns. 
17. Scratching. 
18. Abrasive laser treatments. 

Controlling underlying conditions and watching for early signs of any problem can go a long way to preventing it.

When you scratched your knee as a child, these scrapes healed on their own, with just a little bandage and a mother’s tenderness, but now that you’re older, the wounds take much longer to heal, sometimes up to several months.

How to control wound healing?

Controlling underlying conditions and seeing for early signs of any problem can go a long way to preventing it.

When you scratched your knee as a child, these scrapes healed on their own, with just a little gauze, but now that you’re older, the wounds take much longer to heal, sometimes up to several months. 

There are some types of wounds called stubborn wounds which resist healing and may result from exposure to radiation (for cancer treatment) or injuries from falls.

The following conditions are the most common causes of wounds becoming uncontrollable: 

1. Diabetes: People with diabetes can have vision problems as well as numbness and pain in the lower legs and feet, which can make it difficult to see or feel cuts and scrapes on the skin.
2. Pressure wounds, also called bedsores, appear in the form of small irritations, but they are serious wounds that can suddenly turn into wide or deep wounds. 

Wounds appear when pressure is applied (when lying down or sitting) to places where the bones are prominent, such as the heels, buttocks, hips, head, and lower back.

Such pressure stops blood flow to the soft tissues above the bones.

3. Venous insufficiency: the veins lose their ability to effectively carry blood to the heart in some elderly people, which can cause significant leg swelling, skin ulcers 

“When you stand, blood pressure rises in veins of legs, and if the valves do not work, The pressure rises to a level so high can affect the skin, which can cause skin rupture and form a wound’’

What is the treatment of wounds?

In the past decade, many new ways to treat wounds.

There are, for example, treatments that use stem cells (cells that can develop into other types of cells) and platelet-rich plasma (concentrations of platelets from human blood containing growth factors).

Also, Materials from the human placenta, and even decellularized skin (skin from a human cadaver, which has had the cells removed, and which provides a structure to repopulate with healthy cells).

However, these treatments are still of limited use.

It’s expensive, not covered by insurance most of the time, and we’re still in the testing phase of how well it works.

Another treatment is spending a period in a hyperbaric oxygen chamber, which delivers hyperbaric oxygen to the person inside that room. 

What is the way to treat stubborn wounds?

Treatment and healing of a stubborn wound requires a combination of methods, and a wound care professional can contribute.

This specialist may be a physician, physician assistant, or certified wound nurse.

The first step is to remove the dead cell tissue, a process called debridement.

Wound care also includes special types of dressings, depending on the individual’s needs, to create a moist and healthy environment for the wound and promote the healing process, and in some cases, skin grafting is necessary.

Another treatment method, based on creating a vacuum around the wound, is method known as negative pressure wound therapy, or vacuum-assisted closure (VAC).

What about medications?

Only one drug has received FDA approval for treating wounds, it’s a topical gel called bicaplermin (Regranex), but this drug has a “black box” warning – the agency’s strongest warning level – for its link to cancer and many drugs still developing.

What is the first aid to deal with wounds?

When you or a member of your family has a cut or abrasion that causes bleeding, follow these steps:

1. Stop the bleeding by applying pressure to the wound with a clean bandage or towel, and if possible or necessary, elevate the injured area above heart level to help reduce blood flow to the area. 
2. Make sure your hands are clean, then clean the wound of foreign particles, such as dirt to prevent tetanus. 
3. Clean the wound and monitor signs of infection with an antiseptic or an antiseptic cream. 

An antiseptic cream such as Bepanthen Plus cream effectively disinfects the wound while at the same time reducing the risk of contamination that can arise because of touching the wound. 

Apply a sterile adhesive pad, such as an adhesive tape, to the wound.

What will happen at the wound Care clinic?

For a patient suffering from a non-healing or chronic wound.

The Wound Care clinic offers patients access to state-of-the-art outpatient clinical wound care and hyperbaric medicine. 

Also, the center for advanced wound care and hyperbaric medicine is the established care program.

And uses the most advanced technology to heal wounds.

What is hyperbaric oxygen therapy?

Hyperbaric oxygen therapy is used as an adjunctive treatment for non-healing wounds that meet specific criteria of 10 to 20% meet them. 

Throughout hyperbaric oxygen therapy treatments, the patients need the concentration of hyperbaric oxygen in the blood near the wound.

During the treatments, the patient breathes hyperbaric oxygen inside a chamber, quickly increasing the concentration of oxygen in the blood which makes healing faster.  

Essentially, hyperbaric oxygen therapy therapy helps heal the wound.

Also, hyperbaric oxygen therapy can help reduce swelling and infection.

Finally:

Proper wound care after injury is an essential element to your health and good healing of the wound.

Also seeking immediate medical care and early wound management are very important things to prevent infection, especially for diabetic patients and diabetic foot ulcers.