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Chronic wounds are a silent epidemic that disrupt, challenge, and risk the lives of over 10.5 million people each year in the United States alone. Chronic wounds—wounds that fail to heal in the expected timeframe or continue to cause issues over an extended period—pose significant challenges in both medical management and quality of life. In fact, chronic wounds represent a significant risk of death. While the public often hears about the life-threatening nature of cancers and neurodegenerative diseases, the truth is a person who develops a diabetic foot ulcer has a 5-year mortality rate that is 5.5x higher than breast cancer and 13x higher than prostate cancer. Other than death, chronic wounds lead to other severe complications, as well. For instance, over two million Americans currently live with limb loss due to chronic wounds, affecting African-Americans at a rate of 2x the rate compared to their white counterparts. Furthermore, a staggering 50% of amputees with vascular disease will die within five years. Understanding the risk factors for chronic wounds helps patients address minor wounds proactively, preventing them from becoming severe and reducing the risk of amputation and mortality.
Here, we’ll explore several key factors that can impede the wound healing process and lead to chronic wounds.
One of the primary reasons for delayed wound healing is infection. A natural wound progresses through the so-called “wound healing sequence” of hemostasis, inflammation, proliferation, remodeling. However, bacterial infections can disrupt the normal healing process and prolong inflammation which not only impedes the body's ability to repair tissue but also heightens the risk of additional complications. Effective wound care and prompt medical intervention are essential in managing infections to avoid hindering the healing process. Some strains of infection, such as those caused by drug-resistant MRSA, pseudomonas, acinetobacter, and others, are particularly difficult to heal. Products like NOxyDERM can be instrumental in preventing infections from developing and early treatment is crucial for optimal wound healing.
Diabetes is a chronic condition with several complications that can severely impact wound healing. First, elevated blood sugar levels impair immune function, increasing the chance for infection. Second, diabetes contributes to poor blood circulation essential for bringing healthy building blocks needed for effective wound repair. Third, diabetes reduces the amount of available nitric oxide, the body’s natural molecule that directs the wound healing process, crippling the wound’s natural healing timeline. Because of these reasons, diabetic patients are at a higher risk of developing chronic wounds, especially in the lower extremities, which can lead to more serious complications if not managed properly.
As people age, various physiological changes can slow down the healing process. As the body ages, it naturally produces less nitric oxide, the body’s molecule responsible for healthy skin and wound healing. This leaves older adults with reduced skin elasticity making the skin more fragile and prone to injury, decreased collagen production which is an essential building block in wound healing, and a weakened immune system. These factors combine to make wound healing less efficient, increasing the likelihood of wounds becoming chronic.
Vascular diseases, such as peripheral arterial disease (PAD) and chronic venous insufficiency (CVI), significantly contribute to the development of chronic wounds. These conditions impair blood flow, stunting the delivery of essential oxygen, nutrients, and nitric oxide to the tissues, which are crucial for wound healing. In PAD, narrowed arteries reduce blood flow to the extremities, often resulting in non-healing ulcers, particularly on the feet. Similarly, CVI causes venous hypertension and edema, leading to venous leg ulcers that are difficult to heal. Effective management of these vascular conditions is essential to improve wound healing outcomes and prevent chronic wounds.
Nutrition plays a vital role in wound healing. An inadequate intake of essential nutrients—such as healthy greens (which help stimulate nitric oxide production), proteins, vitamins, and minerals—can impair the body’s ability to repair and regenerate tissue. Ensuring a balanced diet that supports the healing process is crucial for those recovering from wounds.
Smoking has long been known to have adverse effects on health, and wound healing is no exception. Nicotine and other chemicals in cigarettes constrict blood vessels, reducing blood flow and delivery of oxygen, nutrients, and nitric oxide to a wound site. This diminished circulation can exacerbate healing and increase the risk of wound complications.
Immunosuppression can severely hinder the body's ability to heal wounds. Normally, the immune system orchestrates a series of events involving various cells and signaling molecules (like nitric oxide) to manage inflammation, fight infection, and promote tissue regeneration. However, patients who are immunocompromised or who are undergoing immunosuppressive therapies, often used in conditions like organ transplants or autoimmune diseases, have impaired cellular and molecular signaling processes. This disruption leads to reduced inflammation control, slower removal of dead tissue, and diminished formation of new tissue, ultimately resulting in delayed or incomplete wound healing.
Ischemia, or poor blood flow to the wound area, is another significant factor that can hinder wound healing. It can be caused by chronic conditions as discussed above, or other systemic or local conditions, including blockages in the vasculature, inflammation, and even severe burning. Without access to healthy blood flow, the affected tissue is starved of essential oxygen, nutrients, and nitric oxide that are critical for repair. When blood supply is compromised, whether due to vascular issues or external pressure, the healing process slows down, making the wound more susceptible to complications.
Obesity complicates many aspects of wound healing. First, fat tissue can cause poor circulation, which limits the amount of blood, oxygen, nutrients, and nitric oxide that can reach the wound. Second, obesity can aggravate inflammation and impair the body’s immune response. Obesity is also often associated with conditions like diabetes, which further complicate wound healing as discussed above. For wounds that are weight bearing or that receive pressure, excess or repeated pressure on the wound site can impair circulation or damage surrounding healthy skin, both of which can lead to complications and slow the healing process. Managing weight and addressing related health issues can be an important part of wound care.
Certain medications can interfere with the body’s natural healing processes. For example, corticosteroids and chemotherapy drugs can suppress the immune system and slow down tissue repair. If you are on such medications, it is essential to work closely with your healthcare provider to manage their impact on wound healing.
Individuals who have undergone radiation therapy may experience damage to the skin and underlying tissues, which can complicate wound healing. The affected tissues are often more fragile and less able to repair themselves, making it important to adopt specialized wound care strategies in such cases.
Nitric Oxide and Chronic Wounds
Many of the health risks mentioned above are linked to nitric oxide deficiency. Nitric oxide is a molecule that the body synthesizes to coordinate the wound healing process. As we age—and especially when combined with chronic health conditions—our nitric oxide levels decline, impairing our ability to heal even minor wounds. This makes it crucial for patients with conditions listed above to take cuts, scrapes, and burns seriously, as their healing capacity may be compromised. NOxyDERM is an effective wound care product to clean and prevent even simple wounds, such as cuts, scrapes, and burns, from advancing to chronic states.
Chronic wounds, often characterized by reduced nitric oxide, can significantly impact quality of life and pose complex challenges. By understanding and addressing the various risk factors—such as infection, ischemia, diabetes, and lifestyle choices—individuals and healthcare professionals can work together to prevent chronic wounds and promote effective healing. Proper management of these risk factors through medical care, lifestyle changes, and nutritional support is essential for improving outcomes and enhancing overall well-being.
If you or someone you know is at risk for chronic wounds, consult with a healthcare professional to develop a comprehensive treatment plan tailored to individual needs. Consider using NOxyDERM to treat even minor scrapes, cuts, and burns early to help prevent them from becoming chronic and significantly altering your quality of life. Visit NOxyDERM.com for more information.