HEALING OUTCOMES IN A CHRONIC WOUND PATIENT

Chronic wounds are one of the biggest expenditures in today’s healthcare system. These wounds develop in patients with diabetes, peripheral artery diseases, Venous insufficiencies and sometimes as a result of pressure on dependent areas in bedridden patients. Chronic wounds specially have delayed healing because of systemic and cellular changes, repeated reperfusion injuries and bacterial inoculation. There are some general factors that influence wound healing. These include nutrition, smoking status, medications, diabetes, and cardiopulmonary diseases. Patients should be advised protein diet and monitored weekly with prealbumin and transferrin levels for acute changes. Micronutrients like magnesium and zinc have also shown increased wound healing in some trials. Smoking also has been known to delay wound healing as nicotine constricts blood vessels compromising oxygen and nutrients delivery. Medications like corticosteroids affect the wound environment by decreasing fibroblast replication hence decreased collagen production. Apart from this, each unit increase in Hb1AC above 7 equals a worse healing rate, so diabetic patients should be advised strict glucose control.