Causes of poor healing of skin wounds. Why wounds don't heal well

Treatment of most open wounds, including weeping wounds, is based on the ability of the body's cells to repair. Before healthy tissue in the wound begins to gradually recover, it is necessary to ensure that no necrotic areas remain in the cavity. The reparative abilities of tissues begin to manifest themselves only in “clean” areas.

Weeping wounds on the legs become a consequence of trophic disorders due to varicose veins, thrombosis and thrombophlebitis, and erysipelas. Diabetes mellitus is a provoking factor. With the disease, they often form.

Treatment of weeping open wounds on the legs is divided into several stages that coincide with the stages of the wound process. The course of the physiological process of healing of any wound directly depends on the biological reactions in the cells. Modern surgical science considers three main stages of the wound process:

Primary self-cleaning of the wound surface.
Inflammatory reaction of adjacent areas.
Formation of granulations.

Especially often, such wounds appear on the legs. At the first stage, reflex compression of the lumens of blood vessels occurs. This is necessary for the formation of an accumulation of platelets, the formation of a blood clot that will clog the lumen of the damaged vessel and stop the hemorrhage.

Then the lumen of the vessel expands, and the neurohumoral regulation of vascular tone is blocked. As a result, blood flow in the wounded area slows down, the permeability of the vessel walls increases and the release of fluid from the vascular bed into the soft tissues with the formation of edema. Excess fluid begins to be released from the soft tissues, as a result the wound begins to get wet. The described process helps to cleanse dead areas. The main treatment at this stage is aimed at eliminating pathogenetic mechanisms and improving tissue cleansing.

The second stage of the wound process is characterized by the development of clinical and pathogenetic signs of inflammation. Swelling will increase, leading to increased weeping of the wound. The affected area becomes hyperemic, red, and hot to the touch. In injured tissues, there is an intensive accumulation of breakdown products that have an acidic environment, leading to local metabolic acidosis. To remove damaged cells from the body, a large number of leukocytes rush to the wound, and antibodies are released. At this stage, emphasis is placed on anti-inflammatory treatment

The third stage usually coincides with the second. There is an increased proliferation of new young granulation tissue cells. It begins to fill the wound cavity. When a weeping wound is formed, granulation proceeds sluggishly and slowly.

Primary treatment of weeping wounds

Often weeping in the wound is caused by the addition of an infectious process and increased inflammation. In such a case, primary treatment at the first aid stage includes thorough washing of the wound from pus, exudate and dirt. The most effective means for treating the surface of a weeping wound are antiseptic solutions. Choose a solution of hydrogen peroxide, aqueous solutions of potassium permanganate or furatsilin, chlorhexidine. The skin around the wound must be treated with an alcohol solution of iodine or brilliant green. The wound is covered with a sterile bandage, protecting it from dust and pathogenic microorganisms.

Further treatment depends on the cleanliness of the wound; relieving swelling and removing necrotic particles becomes the principle that ensures quick and effective treatment

If the ulcer on the leg is deep, surgical treatment is sometimes used in the form of excision of the damaged areas. The method ensures rapid cleaning of the wound from pieces of dead tissue, which, according to surgeons, becomes an integral component that speeds up treatment.

Under general anesthesia or local anesthesia, the surgeon removes pieces of dead tissue, blood clots, and excises the affected tissue. Sutures are sometimes not applied immediately - the decision depends on the nature and condition of the surrounding soft tissues. In some cases, it is advisable to leave the wound open. The next step is to apply a sterile aseptic dressing.

The described measures make it possible to prevent serious complications: sepsis, tetanus or gangrene. The earlier the treatment is performed, the more favorable the process in prognostic terms.

Principles of treatment

Weeping wounds on the legs are often caused by excessive secretion of serous or fibrous exudative fluid from soft tissues. Caused by an increase in pressure in the affected tissue areas, reduced osmotic pressure in the blood plasma. The reason for the decrease is low plasma protein concentration. These secretions have a physiological meaning and are needed for the healing process to proceed faster. However, excess exudate can be harmful to the wound and requires removal.

In this situation, the most reasonable approach would be to frequently change wet dressings. They must be changed immediately when they get wet. After each change of dressing, the surface of the wound must be treated with an antiseptic solution, for example, an aqueous solution of Furacilin. An alternative solution would be Miramistin, Betadine or aqueous preparations based on iodine.

To reduce the amount of exudate, conditions can be created for the fluid to drain along an osmotic pressure gradient. For a similar purpose, bandages that are moistened in a hypertonic solution are used on open injuries.

The combined effect of ions in the solution leads to normalization of the pressure of interstitial fluids and helps to effectively treat swelling of soft tissues. The bandage with the solution is changed at least every 5 hours.

To reduce swelling and prevent infection, use Fuzidin gel, streptocide-based ointment, Nitacid. It is permissible to treat locally with sulfonamide drugs.

Levomekol ointment is considered an indispensable remedy for treating a weeping ulcer. Popular among practicing surgeons, it perfectly promotes tissue dehydration and accelerates healing. The composition includes an antibacterial and anabolic substance that promotes reparative processes. The ointment is usually applied on napkins or injected directly into the wound cavity.

To dry excess liquid, use Xeroform or Baneocin powder, which has an antibacterial effect.

How to cure a purulent, weeping wound

The main task that the treatment of an open purulent weeping wound is aimed at is creating conditions for the constant outflow of purulent contents. If there is an accumulation of purulent masses, this is fraught with the spread of inflammation to neighboring tissues, the formation of extensive purulent processes, or even sepsis. Treating the conditions described will be more difficult.

Purulent, weeping wounds necessarily expand and drain. Local rinsing of the wound cavities with antibacterial solutions is carried out. For example, dioxidin. Since the ulcer can be extremely painful, it is permissible to treat it using local anesthetics: Lidocaine Spray or Xylocaine in aerosol form.

Proteolytic enzymes are widely used to enhance the rejection of necrotic masses. Trypsin or Chemotrypsin powders are dissolved in physiological solution, sterile wipes are moistened with it, and then applied to the wound. For deep damage, the napkin is placed deep into the cavity. The tampon is changed every two days. You can treat deep cavities with proteolytic enzymes in dry form - poured into the wound in powder form.

Preventing complications

To prevent the spread of pathogenic microorganisms and the development of secondary infection, a patient in a surgical hospital receives parenteral antibiotics.

A combined ointment is injected into the wound, which contains antibacterial and wound-healing substances. For example, Levosin effectively kills pathogens, eliminates the inflammatory process, and has an analgesic effect. Occlusive dressings with Synthomycin emulsion or Levomekol are used. In order for the treatment of open, weeping wounds to be effective, surgeons recommend not using Vaseline ointments.

Therapy at home

If the size of the lesion is small and shallow, treatment at home is possible. It is allowed to treat with salicylic ointment, applying the product to the surface of the wound, covering it with a sterile bandage. It is possible to use ichthyol ointment in a similar way. Grind the streptocide tablet to a powder and sprinkle on the wound until complete healing.

You can use Rescue Balm, which contains various essential oils, beeswax, and vitamins. It should be remembered that the balm forms a protective film on the wound surface. Before application, it is recommended to thoroughly treat the surface with hydrogen peroxide.

Solcoseryl ointment can be used to treat open, weeping wounds on the legs. It has an excellent regenerating effect and relieves pain well. The drug belongs to the group of reparation stimulants.

By a cut called a violation of the integrity of the skin, carried out using a sharp object. Shallow wounds of this nature affect only the dermis and subcutaneous fat layer. Their treatment most often does not require any special means. Deeper cuts are called incise wounds. As a result of such damage, the integrity of the muscles, ligaments, tendons and nerves, as well as blood vessels, is compromised. Such wounds can be dangerous, and the patient should definitely see a doctor.

The main factor causing cuts is the careless use of sharp objects both at home and at work. Cuts can also appear due to injury, including an attack.

Also, wounds of this type appear when falling on glass or untreated knotty logs, after which glass fragments or wood chips can be found in the wound. Sometimes cleaning the wound is very difficult, then you need to consult a doctor. In rare cases, it is even necessary to take an x-ray to detect fragments. It is prescribed if the wound does not heal for a long time, the tissue turns red and exudate oozes from it.

Kinds

Cuts vary depending on the type of object used to inflict them:

blunt objects that leave wounds with ragged edges. Such wounds usually appear in the bone area ( on knees, fingers). The tissues around such wounds become very swollen and severely injured, scarring is more difficult, since their edges are uneven,
sharp objects that leave cut wounds. Such wounds can be quite deep and affect not only the upper layers of tissue, but also deeper ones,
thin and sharp objects that leave puncture wounds,
combined injuries that remain after exposure to sharp and blunt objects.

What symptoms should you look out for?

Most often, bleeding from a cut stops after 10 minutes without the use of any means. If it does not stop for 20 minutes or longer, and also if the wound was caused by a rusty, dirty object, if there is earth or pieces of glass in the wound, you should definitely see a doctor.

In addition, you need to visit a doctor if the antitetanus serum was administered more than 5 years ago, and the injury was caused by a rusty or dirty object.
If the cut is on the face, the wound is long or deep enough, if its edges are not closed with an adhesive plaster, you need the help of a doctor. Deep wounds in the joint area, on the chest, neck, face, and palms are dangerous. You should also definitely show the wounds to a doctor if the victim is a baby, if the tissue around the wound turns red, swells and hurts. These are signs of infection. Attention should be paid if the tissue around the wound has lost sensitivity. If the bleeding does not stop, the victim has impaired motor skills of the limbs or fingers, or if he is in shock, an ambulance must be urgently called.

Complications

trauma to large veins and arteries,
cut infection ( the wound hurts, becomes covered with pus, turns red),
tetanus This is a serious disease that affects the nervous system. It is incurable. The pathogen develops in deep wounds without access to oxygen. To prevent the development of the disease, anti-tetanus serum is administered, which is effective for ten years.

Incised extensor tendon injury

The extensor tendons begin at the nail phalanges and end toward the middle of the forearm. It is through these tendons that impulses are transmitted from the muscles to the fingers for their extension. If in the upper part these tendons are quite thick and round, then near the nail phalanges they look like flat ribbons.

These tendons are adjacent to the bone from below, and are covered only by skin from above. That is, it is not difficult to damage them. Even a small cut can cause injury. Often they are torn away from the place of attachment to the bone, while the skin may not even be torn. Once the tendon ruptures, the finger can no longer fully straighten.

In case of cuts, the tendons are sutured surgically. Often a tendon injury is combined with a bone injury or extensive soft tissue injuries. In such cases, treatment becomes more complicated, prolonged and may not lead to an absolute cure. Sometimes a whole series of surgical interventions is needed to achieve results.

Treatment and stopping bleeding

Treatment of shallow and non-extensive cuts consists of the following activities that the victim or people nearby can perform without the help of doctors:

cleansing the wound,
blood stop,
sterile wound closure,
antiseptic treatment.

Cleansing the wound carried out using water and soap solution. Washing should be done with a piece of cotton wool or bandage. Quickly washing the wound removes sources of infection and prevents suppuration of the wound. After soaping the wound, rinse the soap thoroughly with clean water. This procedure must be done daily until the wound is completely scarred.
If the wound is very dirty, you can also use 3% hydrogen peroxide or an antiseptic solution.

The wound closes by applying a sterile dressing. Before doing this, it should be blotted with a clean cloth or bandage to dry after washing. Carefully examine the condition of the wound - it should be clean, the tissue should not be torn, move the edges of the cut together. After which a sterile bandage or napkin should be applied to the wound.
If a small child has a cut on the lips or chin, do not apply a bandage, as it will collect food and saliva.
A sterile dressing should not be changed frequently, unless the dressing is loose or dirty. But even in this case, you can not change the bandage, but only bandage it on top again with a clean bandage.

How to stop bleeding?
The fastest way is to press the top of the cut with a clean bandage or cloth. The bandage must be pressed tightly enough and held until the bleeding stops ( sometimes up to a quarter of an hour). This procedure is ineffective only if the arteries are affected. To make the blood flow less intensely, you need to raise the wounded limb upward.

Wounds on the head almost always cause heavy bleeding, since there are a lot of blood vessels, and it is often necessary to call a doctor to stop the bleeding.

If blood leaks through a tight bandage that has already been applied, you should bandage it even tighter with another piece of bandage. You should not remove the first bandages, as in this case you can break off the already clotted blood and resume bleeding.

When the bleeding has stopped, you need to bandage the affected area quite tightly, but at the same time do not squeeze it completely - this will stop the blood supply to the tissues. There is no need to make a hoop of adhesive tape around the limb, which can also disrupt the flow of blood. To understand how correctly the bandage is applied, you should press down the nail on the bandaged limb. It first turns white, after which it should quickly return to its pink color. Otherwise, the bandage is too tight and should be loosened a little.

Without special need, you should not resort to a tourniquet, since with the help of this remedy you can significantly worsen blood circulation in the affected limb. A tourniquet should be used only in case of urgent need.

Bleeding that does not stop after a quarter of an hour can be dangerous! You should call an ambulance or go to the doctor.

Treating the wound with antiseptics
This event is carried out to prevent wound infection. Most antiseptics suppress the inflammatory process and reduce the duration of scarring.

Antiseptics can be in the form of a solution in alcohol, water or in the form of a cream.
Aqueous solutions are used to treat wounds, as well as to wet tampons and napkins for sterile dressings. This treatment is completely painless and is often used to treat wounds in children.

Alcohol solutions can burn the edges of the affected tissue and prolong the scarring process. Such preparations should be coated around the cut. If the solution gets on the wound, it will sting and the skin around the wound will turn red.

The ointment can be used to treat both the wound itself and the napkin that is placed on it. If the wound is wet, the ointment may prolong the scarring period. If the wound is generously treated with ointment and a tight bandage is applied to it, maceration is possible ( softening) edges.

What to do if your finger is injured?

If your finger is cut in the kitchen and the wound is bleeding quite heavily, you should not try to stop the bleeding by putting your finger under cold water. Such measures will provoke even more bleeding. The best thing to do is just give it a thumbs up.

The skin around the wound should be coated with iodine, and the surface of the wound itself should be treated with 3% hydrogen peroxide. It is forbidden to smear the wound with Vishnevsky ointment or ichthyol ointment, which are so popular among the masses. Next, apply a tight bandage to your finger.
Here's a little secret: how to put it on your finger so that it is convenient for them to operate, and so that the bandage does not move out. Regular bandaging of a finger most often only leads to the fact that the bandages slip off after a while. And sometimes they dry to the wound, and changing the dressing is then painful and unpleasant. To prevent all these troubles, you should wrap your finger at the cut site with a strip of paper that covers the entire phalanx. After which you can wrap a bandage or stick a patch. Such a paper wrapper will protect the wound, move its edges and help it heal faster.
This type of bandage is easier to remove because the paper will not stick to the wound. According to experienced people, it is best to use white stationery paper. Before application, it should be treated with hydrogen peroxide.

Ointment treatment

Dexpanthenol
It is produced in the form of ointment, spray, cream and lotion. Contains vitamin B5, quickly heals wounds, restores tissue, and can be used to treat mucous membranes. Treat the affected area once a day.

Chamomile ointment
Relieves inflammation, antiseptic, accelerates tissue restoration. Wounds are treated once a day.

Comfrey ointment
Relieves inflammation, stops bleeding, accelerates tissue restoration. Prescribed if the cut does not heal for a long time. The affected surface is treated two or three times a day and a bandage is applied before bedtime.

Calendula ointment
Relieves inflammation, destroys microbes, accelerates tissue restoration. It is very indicated for long lasting cuts. Treatments are carried out several times a day.

Betadine
Produced in the form of iodine solution and ointment. Strong antiseptic. May cause local skin irritation.

Etonia ointment
Inhibits the development of pathogenic microbes, relieves pain, and accelerates scarring. Treatment is carried out once or twice a day. Effective for purulent wounds.

Lifusol
Antiseptic, inhibits the development of microbes. Prescribed for the treatment of wounds, including very dirty ones ( first washed with an aqueous solution, then ointment is applied).

Special instructions for the use of certain medications

If the cut does not heal for a long time, you should take a course of vitamins B, C, E and A,
Treatment of wounds with iodine can provoke individual intolerance,
People who have impaired thyroid function should use iodine supplements only under the guidance of a doctor.
Solutions of boric acid cannot be used to treat large surfaces of the body, as the drug is absorbed into the blood and poisoning may develop. This is very dangerous for children. Signs of boric acid poisoning: nausea, rash, kidney failure, diarrhea,
Alcohol preparations should not be applied to the wound surface, using them only to lubricate the skin around the wound,
Since any alcohol preparations cause a burning sensation, they are not advisable to use in the treatment of wounds in children,
Deep cuts should not be treated with hydrogen peroxide, as air bubbles may clog the blood vessels.
Lifusol ointment creates a thin protective film on the surface of the wound, which protects the wound from germs. You can remove it by wiping the body with alcohol,
Lifusol is a flammable product. In addition, you should not give the tube of ointment to babies.

Antibiotics

In order to prevent the development of pathogenic microflora in not very large cuts, most often only antibiotic ointments are enough. More effective are drugs containing neomycin, tetracycline, bacitracin, polymyxin sulfate, as well as combination drugs. Treatment of an untreated and uncleaned wound with an antibiotic within four hours after injury helps reduce the likelihood of complications, relieves pain, and accelerates tissue regeneration. But it is advisable to treat an already cleaned cut.

Antibiotics should not be used for too long, as this may create favorable conditions for the development of superinfections ( mycoses). If the cut is quite extensive and even using an antibiotic for five days does not produce results, you should definitely visit a doctor.

Ointments containing antibiotic:

syntomycin liniment,
levomekol,
methyluracil,
gentamicin ointment,
levosin.

What affects the speed of healing?

1. Poor supply of blood and oxygen to the tissues adjacent to the wound. The more oxygen there is in the tissues, the more actively phagocytes work in it - immune cells that absorb pathogenic organisms, blood vessels are restored faster, the condition of the epithelium is normalized, and collagen production is accelerated. Lack of oxygen occurs in people with diseases of the heart, lungs, and blood vessels who have lost a large amount of blood.

2. Body weight, age and diet of the patient. To produce collagen fibers, you need proteins, minerals and vitamins, as well as carbohydrates. Thus, vitamin A is needed for wound epithelization, vitamin C helps normalize the condition of cell membranes, and zinc accelerates cell recovery. In older people with increased body weight, inflammatory processes take longer, and collagen is produced slowly.

3. Pathogenic microbes. Microbes are sure to immediately penetrate into the wound. And only phagocytes can destroy them. If the victim has poor immunity, the wound is very dirty, there are fragments and dead tissue left in it, then the phagocytes will not cope with their work. The production of repair fibers deteriorates, scarring is inhibited, and inflammation lasts longer. Microbes absorb oxygen needed by body tissues. The main dangers for wounds are pyogenic and fecal streptococci, Staphylococcus aureus, Klebsiella, Pseudomonas aeruginosa and Escherichia coli.

4. Diabetes. In such patients, all cuts are scarred very hard and for a long time.

5. Taking certain medications. For example, in patients using glucocorticoids, immunosuppressants, vascular restoration and collagen production are inhibited and local immunity is worse.

How to get rid of scars?

Cut scars can disfigure any part of the body. But you can get rid of them. It should be borne in mind that the less time has passed since the injury, and the shallower the depth of the wound, the more effective the treatment of scars will be.
To choose the right method for removing a scar, you must first keep in mind the nature of the injury and its depth.

If the cut was very shallow, you can use the microdermabrasion method - this is a type of gentle peeling that removes only the very top cells of the dermis. The skin is treated with a diamond "abrasive wheel" that exfoliates dead cells to speed up recovery. The treatment does not cause any discomfort at all. Sometimes it is necessary to carry out several procedures. At the same time, between procedures the skin looks normal, the body does not need to recover as after more stringent procedures.

If the cut scars are deep enough, a chemical peel should be used. This is a very effective procedure. The skin is exposed to acids, phenol and retinol, which remove not only the upper but also the deeper layers of the dermis, leveling it. After the procedure, skin regeneration occurs in about 7 days.

When should you definitely see a doctor?

In some cases, it is not enough to just treat the wound yourself. A doctor should be called if:

blood spurts out of the wound; if the blood is scarlet, a blood vessel is probably cut,
blood flows profusely and does not stop,
the cut is in a visible place and the scar on it is undesirable,
the hands are affected - there are important tendons and nerves here,
symptoms of inflammation are present - redness covering the tissue more than 2 cm around the cut, swelling of the tissue,
increase in body temperature,
the wound is deep enough - in such cases it is necessary to apply a suture,
the wound is dirty, and the last tetanus shot was given more than five years ago,
soil and animal feces got into the wound ( for example, manure) – in such environments there is a lot of tetanus pathogen,
the wound does not heal long enough, exudate flows from it,
after injury, the victim vomits and feels sick - this is more true for head injuries in children.

Doctor's help

How can a doctor help with deep or dirty incised wounds?

clean the wound from dirt and debris,
put stitches,
if nerves, tendons or blood vessels are damaged, send them to the hospital,
prescribe antibiotics if the wound is infected,
give an anti-tetanus injection.

Before use, you should consult a specialist.

Wound healing depends on many factors, taking into account the condition and immune system of the human body, the presence of chronic diseases, as well as the competent provision of first aid. Local problems

Often the reason for long wound healing is infection of the wound, leading to the formation of purulent processes. To prevent this, you should know how to properly disinfect and how to treat a purulent wound in order to speed up the healing process as much as possible.

Immediately after damage, the following manipulations must be carried out:

Remove foreign bodies from the wound, if any;

Treat the wound surface and the skin around it with an antiseptic to prevent infection;

Use a sterile dressing for initial dressing. In the future, in order for the wound surface to heal faster, you should follow simple rules: . do dressings more often; . carry out antiseptic treatment, even if there is no infection - do not allow the wound to heal for a long time;

Stimulate healing with special medications that can create a protective film on the surface.

If you follow all the rules, the wound surface will begin to dry out, which is an important factor for rapid healing. Help her with this. There are wound healing agents for this. If the development of a purulent process begins, then without delay, you need to consult a doctor who will advise how to treat the purulent wound and what other measures to take for effective treatment. The problem lies inside the body If even the smallest wounds and scratches take a long time to heal, then this may be due to internal problems of the body.

The most common of them:

Diabetes;

Skin diseases (psoriasis, eczema);

Oncological diseases;

Failure of the immune system;

Exhaustion;

Lack of vitamins and microelements.

If prolonged wound healing is observed even with proper initial treatment, it is necessary to urgently contact a therapist who will conduct all the necessary tests and identify the cause. In some cases, for example, with diabetes, even a small scratch often leads to suppuration. If a wound on the leg does not heal, the cause may be impaired trophism.

It is important to know how to treat a purulent wound, since in diabetes mellitus not all medications have a positive effect. How to quickly heal a wound at home?

Rule 1. Careful processing and dressing. The procedure is carried out only with clean and dry hands. It is best if you pre-treat your hands with any disinfectant. It is recommended to carry out dressing in the morning and evening, treating both the wound surface and the skin around it.

Rule 2. Elimination of purulent inflammation. Special ointments with a “pulling” effect or antibiotics will help clear the wound of pus. The main rule is that the bandage with the medicine should be changed at least three times a day.

Rule 3. Drying. If there is no inflammation, then drying gels are used, which promote rapid cell regeneration and lead to rapid recovery. If crusts have formed on the wound, then ointments will be effective. They create a special film that prevents additional damage.

The problem of long healing of various wounds is often a temporary phenomenon. For example, a person recently suffered from an acute respiratory viral infection, which resulted in disturbances in the immune system. However, if the problem of long recovery begins to become systematic, then this can be considered an “alarm bell” for immediate consultation with a doctor.

One of the varieties of this pathology are bedsores. Several processes may underlie slow wound healing:

the presence of a sluggish infectious-inflammatory process;
poor blood supply to the skin in the wound area;
the presence of severe diseases such as diabetes mellitus, malignant tumors, malnutrition, immunodeficiencies, vitamin deficiencies, etc.
improper surgical treatment of the wound.

For normal wound healing, several conditions are necessary: sterility of the wound surface, proximity of healthy skin edges of the wound to each other, good ability of the skin to regenerate. In the absence of these conditions, the healing process is delayed. Small wounds usually heal without leaving a skin scar. Large wounds require significant efforts by the body to “grow” new tissue to replace the existing defect, which is why scars form. Scars, by the way, are more pronounced the more intense the healing process is. So, everything is good in moderation.

Inflammation of the wound caused by infection prevents the synthesis of new skin cells, so until it is removed, the wound will remain open. Therefore, it is so important to initially treat any wound with an antiseptic solution (see below) and if the defect is large in size (more than 1 cm), then it must be covered with a sterile bandage in the first days. At the same time, it is not worth keeping the wound under a bandage for a long time, since high humidity does not contribute to rapid healing.

The diseases listed above significantly impair blood supply to the area of the wound defect and suppress the immune system, which fights infection in the wound. Therefore, treatment of wounds in these cases requires careful treatment of the underlying disease against which the injury occurs.

1st method:

It is necessary to prepare a medicinal product from the following composition: 100 g of coniferous resin-resin (grind or crush), 100 g of lard (preferably fresh), 100 g of beeswax. Mix all the ingredients, put on low heat and bring to a boil, remembering to stir occasionally. Let simmer for 10 minutes. Remove from heat, wait to cool, and transfer while warm to a glass container.

Before using this remedy, the wound should be treated with lime water. It is prepared as follows: 1 tbsp. quench a spoonful of quicklime with 1 liter of water. Let it sit for 5-6 hours. Carefully drain the water and rinse the wound with it. Then take the remedy, smear it on a clean cloth and apply it to the wound. Dress the wound so that the bandage does not fall off. The bandage with the applied treatment should be changed after 1-2 days.

With this method, the wound heals faster. The resulting mixture has an analgesic effect and does not cause irritation.

2nd method:

Prepare a medicinal ointment according to the following recipe, mixing: 80 g of natural bee honey, 20 g of fish oil, 20 g of xeroform. The product is ready. Apply a clean cloth to the surface and wrap the wound as a bandage. It is necessary to change the bandage after 1-2 days. The medicinal ointment must be stored in the refrigerator.

If everything is done correctly and hygienically, but the wound still does not heal and a purulent process develops, you need to seek help from a specialist. The doctor will examine the sore spot, recommend a medicine for its treatment and help take additional measures for effective treatment.

Why does the wound take so long to heal?

The reason for the wound not healing for a long time may be inside the body and be associated with internal problems. The most common of them are:

skin diseases (eczema);
failure of the immune system;
oncological diseases;
lack of vitamins and microelements in the body;
exhaustion of the body;
lack of hemoglobin ().

If wounds do not heal for a long time, you should consult a doctor. You may have to treat not only the wound, but also the serious reason why it is not healing for a long time.

In order for a wound to heal normally, certain conditions must be met: good indicators of the ability of the skin to regenerate, the proximity of healthy wound edges to each other, and absolute sterility of the wound surface. The presence of general diseases in the patient that worsen regeneration processes (vitaminosis, diabetes mellitus, cachexia in malignant tumors, syphilis, etc.) also often leads to secondary healing of not only accidental, but also surgical wounds.

Wound healing at a slow pace can be observed due to certain processes outlined below: - Surgical actions to treat purulent wounds and not only purulent ones were carried out incorrectly. - Vitamin deficiencies, immunodeficiencies, malnutrition. - Malignant neoplasms, diabetes mellitus and some other severe diseases. - There is poor blood supply in the wound area. - The presence of an inflammatory-infectious process characterized by a sluggish course. Wound inflammation, caused by infection, prevents the synthesis of new skin cells. In this regard, until the inflammation is eliminated, the wound will remain open. To eliminate inflammation, that is why an antiseptic is used, which must be used to treat every wound (even the most minor one). If a defect is large enough in size (more than 10 millimeters), then a sterile bandage should be used in the first stages to cover it. At the same time, it is undesirable to keep the wound under a bandage for a long period of time (increased humidity interferes with wound healing and delays this process). Such diseases significantly impair the blood supply to the wound area and also inhibit the immune system, the normal functioning of which is the most important factor in the fight against infection that has entered the wound. In this regard, wound therapy in such situations should be accompanied by high-quality treatment of the main disease against which the wound progresses. The healing process is much longer if the above conditions do not exist. Without the formation of a skin scar, as a rule, healing of small wounds occurs. If the wound is large, then “growing” new tissue requires significantly greater efforts from the body aimed at replacing the defect that has formed. In this regard, the formation of a scar on the skin is observed. It is worth noting that the severity of scars directly depends on the activity of the healing process - the more intense the healing, the more pronounced the scar will be. Thus, it turns out that everything should be in moderation. A distinction is made between primary healing, when with close, touching edges and walls of the wound, healing processes proceed quickly, without complications, and secondary healing, when there is a large wound cavity, many dead tissues, a purulent infection has developed and regeneration processes proceed slowly, through the formation of granulations. Healing of purulent wounds, as a rule, occurs by secondary intention. Unsutured wounds with divergence of edges and walls, wounds filled with blood clots, and the presence of foreign bodies or necrotic tissue, also heal by secondary intention. The healing processes of purulent wounds occur in the following sequence. First, the wound is cleared of necrotic tissue, cells, blood clots, etc. Then, in certain areas of the walls of the purulent cavity, cell growths appear in the form of red nodules, which, gradually increasing in number and size, cover all the walls and bottom of the wound. One type of such pathology may be bedsores.

Surgery's View

Depending on the nature of the wound, the size of the wound, its infection, the characteristics of the body’s reactivity, etc., healing of the wound defect can occur by primary intention, under a scab, or by secondary intention (through suppuration). If the wound defect is small (for example, with a linear tissue incision), the wound does not gape, its edges seem to stick together, the thin fibrin film that forms between them quickly grows with fibroblasts and blood vessels and heals with the formation of a narrow, often barely noticeable scar. In these cases, they talk about wound healing by primary intention. When healing under a scab, the scab formed on the surface of small wounds, abrasions and scratches is a dried protein mass of blood, lymph, and dead tissue. Epithelization of the wound surface occurs under the scab, which, upon completion, disappears. In some cases, large scabs form with extensive scalp wounds and burns. However, healing occurs under the scab by secondary intention - through suppuration and granulation. Preservation of a scab in such cases often leads to the accumulation of purulent discharge under it and the development of severe perifocal inflammation. Treatment of purulent wounds under the scab follows the general principles of management of purulent wounds. Healing by secondary intention is typical for wounds with a large area of damage (if the edges of the wound are far apart), when there is non-viable tissue in the wound, a hematoma, or when an infection develops in it. In this case, wound cleansing through suppuration due to the proteolytic action of cellular and microbial enzymes, significant development of granulation tissue and its organization, subsequent scarring and epithelization with the formation of a rough scar are observed. The duration of the phases of the wound process during healing by secondary intention varies significantly depending on the size of the wound, the amount of dead tissue, the degree of bacterial contamination, the general condition of the body, etc.

What to do

For the speedy healing of a wound, certain vitamins are needed that are actively involved in regenerative processes. These vitamins are considered to be B vitamins (B5, B2, B1) and vitamin A. As you can see, the effectiveness of treating wounds that heal poorly depends on how well the skin stimulation is carried out, on how well the blood circulation in the wound area has improved and on whether appropriate sterile conditions have been created. Actively use wound healing agents. Therapeutic measures should improve regeneration processes and create unfavorable conditions for the development of microorganisms in the wound. The complex of therapeutic measures includes agents that act locally on the wound, and general ones that act on the entire body. Both should help improve the conditions for the natural course of the wound process. They should be different for fresh and treatment of purulent wounds, in different phases of the wound process, as well as with different severity of the process (hypoergic, normergic and hyperergic type of body response). The general objectives of wound care are: 1) the ability to anticipate and prevent wound hazards; 2) reducing the number and virulence of the infection; 3) removal of dead tissue; 4) strengthening of regeneration processes.

Features of wounds

A wound after radiation therapy is not uncommon. It is necessary to treat with medicinal ointments such as solcoseryl, iruksol to clean the wound, followed by the use of wound-healing ointments (such as Actovegin). Wounds do not heal for a long time due to anemia or latent iron deficiency. To exclude them, it is necessary to take a general blood test, serum iron, vital blood test, ferritin.

A clean ulcer does not heal

If the trophic ulcer is not inflamed and there is no pus or necrosis, exudation is weak or moderate, you should use products that have a stimulating wound healing effect and maintain an optimal level of moisture in the wound. Trophic wounds on the leg are especially dangerous. Wounds should not be dried out; the appearance of a crust on the surface of the wound should be avoided. For effective treatment, use chitosan-based products, hydrocolloid or hydrogel binders.

The wound does not heal after tooth extraction

After tooth extraction, the process of normal wound healing lasts approximately 4 months. The edges of the gums come together, and at the same time a blood clot forms in the socket, which is replaced by granulation, then osteoid (bone) tissue. The process of normal healing of the hole is painless. On the 3rd day after removal, the first signs of wound epithelization appear. In the 4th month, new bone forms in the upper part of the socket, which over time acquires a normal spongy structure. With the formation of bone tissue, the edges of the socket and alveoli are absorbed by approximately 1/3 of the length of the root. Over time, the alveolar ridge in the area of the extracted teeth becomes lower and thinner. Above the mouth of the hole it has a concave or wavy shape. In the absence of a blood clot, the socket heals as a result of the formation of granulation tissue from the bone walls of the socket. Gradually, the edges of the gum above it come closer together, the hole is filled with granulation, then osteoid tissue. Subsequently, the process of bone formation occurs in the same way as described above. In cases where the socket is infected or the bone or edge of the gum is injured during surgery, regenerative processes proceed more slowly. In these cases, an inflammatory process develops in the tissues surrounding the wound, so the onset of bone regeneration and epithelization of the wound is delayed. Very often, tooth extraction is resorted to when there is inflammation in the socket, so wound healing after the removal of such a tooth occurs at a later date than when removing non-inflamed teeth; instead of 3-5 days, the process takes 10-14 days. The first signs of bone formation appear on the 15th day. The resulting osteoid beams are layered on the walls of the socket. Epithelization of the wound is often completed only on the 30-50th day. As the wound is cleansed of dead tissue, granulation tissue grows from the walls and bottom of the hole. Only after 1.5-2 months. Most of the socket is filled with osteoid tissue, which will gradually turn into mature bone. A more significant delay in bone formation and wound epithelization occurs during traumatic tooth extraction with gum rupture and damage to the walls of the socket. In these cases, the edges of the gums do not come together for a long time.

Diabetes does not heal the wound

Trophic ulcers (long-term non-healing wounds) are the most common form of diabetic foot syndrome. Of fundamental importance is that diabetic ulcers are divided into neuropathic (in patients with normal blood flow to the legs, and neuro-ischemic (or ischemic) - arising against the background of impaired blood flow. A small proportion of patients with diabetes suffer from leg ulcers - such ulcers are usually are a consequence of venous diseases (venous insufficiency). Proper local treatment. Treatment of the wound with the application of a new therapeutic dressing is carried out daily or once every 2-4 days (depending on the condition of the wound and the type of treatment used). Use of modern dressing materials (non-stick wound, unlike gauze). Today, a large number of such materials are available, belonging to various classes - alginates, hydrophilic fiber, atraumatic meshes, polyurethane foam dressings, hydrogels, hydrocolloids, etc. The choice of dressing is made by a medical professional (doctor or nurse in a specialized office ) based on examination of the wound, X-ray data, etc. Washing the wound with antimicrobial agents that do not damage growing tissues - such as a solution of miramistin, chlorhexidine, etc. We remind you that iodine, alcohol, brilliant green and potassium permanganate are contraindicated in diabetes, because .To. slow down healing Regular treatment of the wound by a doctor or nurse (removal of non-viable tissue, callus around the wound (often formed with neuropathic ulcers)). Usually carried out every 3-15 days. Protecting the ulcer from the stress of walking. As long as the patient steps on the wound, no matter what expensive medications or dressings are used, the wound will not heal.

Amputation wound

The fate of the limb, indeed, depends mainly on the possibility of restoring arterial blood flow. Roughly speaking, the blood flow in the vessels is sharply reduced, and if it is not increased, the amputation stump will not heal.

Complications during wound healing

Usually manifested by divergence of the edges or its suppuration. Dehiscence of wound edges (R.) without signs of suppuration is rarely observed and develops as a result of disturbances in the general condition of the body (vitaminosis, dystrophy, cachexia, etc.) or defects in surgical technique. Suppuration of R. more often occurs with extensive trauma to surrounding tissues, the presence in R. of areas of necrosis, hematoma, foreign bodies, inadequate comparison of the edges of the wound, microbial contamination above a critical level (105 microbial bodies per 1 g of tissue), general disturbance of the body condition (traumatic shock , large blood loss, etc.). The correct tactics are needed to treat purulent wounds. When purulent R. heals by secondary intention, purulent streaks, phlegmon, lymphadenitis, erysipelas, thrombophlebitis, and gangrene caused by a secondary anaerobic or putrefactive infection are possible.

Wound healing with folk remedies

Boil three sprigs of comfrey (Symphytum officinale L.) in a liter of water until the water boils by half. Strain and rinse with this decoction.
Take one sweet pomegranate, boil it with tart wine and apply a bandage from this mixture to the wound.
Vanga believed that healing medicines are used first in liquid form, and then, as healing progresses, they move on to dry and bulk products. Healing agents include cypress tree bast with rose oil wax ointment, burnt aristocholia, alum, and fig leaves.
To prepare a healing linen plaster, Vanga advised taking washed linen cloth and pounding it until it turns into powder. Then add highly astringent olive oil or sea buckthorn oil and prepare a plaster.
For older people, this plaster is good: burn barley and prepare a wax ointment from it with rose oil or myrtle oil and white lead.
To prepare the powder, take equal quantities of rose flowers, white lead, and pomegranate flowers.
The rapid maturation of abscesses is facilitated by the application of wheat or rye bread crumb dipped in hot milk, gruel from fresh coltsfoot leaves, bird cherry, fresh buckwheat leaves stacked on top of each other.
Wounds are well cleaned of pus and healed by grated onions, carrots and steam of freshly grated onions applied to the wound (treatment for 8 - 10 minutes).
Vanga recommended using fresh aloe tree juice, soaking a gauze bandage with it and irrigating wounds, as well as fresh knotweed grass in the form of a gruel or juice for lotions.
Pour 40 grams of dried celery root with 120 milliliters of olive oil. Apply to the wound.
Infuse the flower tops of dead nettles in a warm place with linseed oil in a ratio of 1:5, and then apply to the wound.
Pour 75 grams of chopped fresh burdock root into one glass of water. Infuse for a day in a warm place. Then boil for 15 minutes, strain. Use as compresses.
Pour 10 grams of wormwood paniculata herb into one glass of boiling water. Infuse, strain. Apply in the form of compresses, lotions
Pour one tablespoon of fresh or dry colza herb into one glass of boiling water. Leave for 2 - 3 hours, strain. Take one quarter glass four times a day for a month.
In case of severe wounds and heavy blood loss, apply a very thick layer of clay directly to the damaged area. It is better to first sprinkle the wound with dry clay powder, and then apply clay, pressing it well, thus eliminating blood loss. If there is any concern that there is some foreign body left in the wound, then there is no need to take additional measures to remove it, because the clay will do that. You will see this for yourself when after several procedures you see a foreign body on the lotion.
If it is difficult to apply a lotion (eyes, ears, etc.), you can do wraps. To do this, take a semi-liquid clay mass, thoroughly soak the fabric with it, apply it to the painful part of the body and cover with a woolen blanket.
Change the canvas soaked in clay mass more often. Use such procedures when you need to expose a large surface of the skin to clay.
You can use small dressings made from a mixture of glycerin and clay (2:1).
In Bulgarian folk medicine, beeswax has long been used in combination with other components to treat poorly healing wounds. To prepare wound healing mixtures, you can use the following recipes. Take 100 g of olive oil, 13 g of wax, 20 g of pine resin (rosin) and one tablespoon of butter. Mix everything in an enamel pan, put on low heat and heat for 10 minutes, stirring constantly and removing the foam that appears on the surface. Transfer the prepared mixture into a glass jar. Apply the mixture to gauze and apply to the wound.
Boil two parts olive oil and one part pure beeswax over low heat. Cool the resulting ointment and transfer it to a glass jar. After washing the wound with hydrogen peroxide, apply a bandage with the prepared preparation.
Wash the wound and apply a compress of nettle leaves: fill the bottle to the top with fresh nettle leaves, then fill it to the top with grape vodka, plug it with a stopper and leave in the sun for two weeks.
Take a tablespoon of goat or sheep fat and half a tablespoon of salt; add a tablespoon of well-chopped onion (the onion should be old), put everything in a strong bowl and grind almost into powder. Take about the size of a walnut of this ointment (this is for a fairly large wound) and put it inside and outside the wound. Then apply a bandage and keep it on for 24 hours. After the first use of this remedy, the patient will feel very severe pain, because the medicine will “eat” into the wound and draw out dirt. The pain will decrease after the second and third application, and with the fourth or fifth it will stop altogether.
The wounds are simply smeared with honey and a light sterile bandage is applied on top.
Infuse half a glass of fresh crushed flowers and leaves of St. John's wort with a glass of almond, sunflower, olive or flaxseed oil for three weeks. Squeeze, strain. Store in a cool place. Lubricate poorly healing wounds with this oil.
The juice of fresh fern leaves heals wounds well.
Prepare a decoction of fenugreek (Greek hay), and apply the remaining pulp to the wound.
Apply the pulp of the puffball mushroom to the wound.
Pour birch buds into a bottle, add grape vodka and leave. Lubricate the wound with tincture.
Dissolve cow butter over the fire, grind fresh birch buds in it, spread it on a cloth and apply.
Boiled and mashed white beans are used to cleanse festering wounds.
Honeycombs and wax are used to treat non-healing wounds. The honeycomb is boiled and applied warm to the wound.