Complications of Wound Healing Example

Complications of Wound Healing Example

Understanding the Role of Immune Regulation in Wound Healing

Wound healing is a complex process that requires complying with the proper rules, requirements, and norms to prevent complications. It is a four-staged system that involves hemostasis, inflammation, proliferation and maturation (Basu & Shukla, 2012). If the normal stages of the wound healing process are interrupted, there may be serious complications which lead to development of chronic and non-healing wounds. There is a need for considering both systemic and local factors that affect would healing. According to researchers, “the culmination of any operation is a healed wound” (Ehrlichman et al., 1991). Hence, health care professionals should recognize the fact that failure of providing effective would healing leads to the increased time the patient will spend in the hospital setting, as well as the increased costs. Due to understanding of the basic requirements for wound healing, including the multiple factors, such as nutrition, and the knowledge and experience of the methods that help to deal with potential adverse factors, namely chemotherapy, corticosteroids, and radiation, it is possible to succeed in this process (Ehrlichman et al., 1991). The major complications of would healing include inadequate scar formation, excessive scar formation, and contracture formation.Complications of Wound Healing Example

To start with, inadequate scar formation stands for inability to ensure formation of a suitable extracellular matrix. As a rule, this type of abnormality in the healing process is characterized by deficient formation of granulation tissue, which may be presented in the form of  dehiscence and ulceration. The first one is caused by the “increased mechanic stress on the wound from vomiting, coughing, or bowel obstruction” (Sephel & Woodward, 2008, p. 97). The second abnormality, namely ulceration, is caused by inadequate intrinsic blood supply or vascularization practices. These are life threatening complications.Complications of Wound Healing Example

Besides, excessive scar formation is another complication of would healing, which is characterized as excessive deposition of extracellular matrix, namely collagen, which results in formation of hypertrophic scar. As a rule, keloid scar can be progressing in a way that leads to occurrence of irregular collagen bundles. This abnormality affects the process of wound healing in a negative way. According to researchers, “this situation indicates ‘a maturation arrest’” (Sephel & Woodward, 2008, p. 97).

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Also, contracture formation or excessive contraction is characterized by the processes that lead to decreased size of the wound. This abnormality is caused by “the presence of myofibroblasts, developmet of cell-cell contracts, and sustained cell contraction” (Sephel & Woodward, 2008, p. 97). This abnormality leads not only to deformation of the would, but also to deformation of surrounding tissues.

In order to avoid these wound problems, it is recommended to provide a good wound bed preparation that involves “enzymatic and surgical debridement, resident fibroblast stimulation and stimulation of growth factor release, addition of extraneous growth factors to the wound, deployment of bioengineered extracellular matrix, collagen and alginates, cultured keratinocyte suspension and even bioengineered dermal preparation in any combination” (Basu & Shukla, 2012, p. 109). In addition, stem cell therapy can be used to address negative health outcomes (Park & Barbul, 2004). There is a need for supporting the  immune system, which plays a critical role in the process of wound healing because immune cells serve as regulators of healing the wound through “the secretion of cytokines, lymphokines, and growth factors” (Park & Barbul, 2004, p.11).

Thus, it is necessary to conclude that to prevent progressive complications, health care professionals should optimize as many factors that affect healing the wound as possible. It is recommended to improve knowledge of the key requirements to normal wound healing in order to prevent potentially problematic wounds. Having the proper knowledge and resources that can help to deal with wound problems guarantee positive health outcomes. This approach involves understanding basic wound healing with its multiple factors, including nutrition, and knowing how to deal with potential adverse factors in wound healing, such as chemotherapy, corticosteroids, and radiation.Complications of Wound Healing Example

References

Basu, S. & Shukla, V. (2012).Complications of Wound Healing. Measurements in Wound  Healing, Springer.

Ehrlichman, R. J., Seckel, B. R., Bryan, D. J., Moschella, C. J. (1991). Common Complications of Wound Healing: Prevention and Management. Surgical Clinics of North America, 71(6): 1323-1351.

Park, J. E. & Barbul, A. (2004). Understanding the role of immune regulation in wound healing. The American Journal of Surgery, 187(5): 11-16.

Sephel, G. C. & Woodward, S. C. (2008). “Repair, Regeneration , and Fibrosis” in Rubin’s  Pathology: Clinicopathologic Foundations of Medicine, ed. by Raphael Rubin, David S.Strayer, Emanuel Rubin, Jay M. McDonald. Lippincott Williams & Wilkins.Complications of Wound Healing Example

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