Updated: Feb 6, 2018

Wednesday, 07/19/17, 9:00am

Welcome back to our Skilled Wound Care Insights series!

Today we’ll be discussing possible reasons why a wound isn’t healing, and offer some helpful suggestions to consider.

DIDN’T HEAL: A mnemonic

One of the handiest ways to remember the possible causes that impede wound healing is with the mnemonic DIDN’T HEAL:

D (Diabetes): On the clinical level, diabetes causes diminished vision, sensation, and immunity, leading to the formation of wounds. This disease also acts on a cellular level, impeding blood flow to the lower extremities. It impairs the inflammatory and proliferative phases, predisposing patients to infection.

I (Infection): Infection blocks proper wound healing, and creates a sustained inflammatory response, preventing the remainder of the healing cascade from occurring correctly.

D (Drugs): Any medications which are immunosuppressive also impede wound healing.

N (Nutritional problems): Lowered caloric intake and protein levels, as well as any vitamin and mineral deficiencies can cause a reduction in healing.

T (Temperature extremes): Extremely hot or cold weather, or temperature extremes in the wound itself, will not allow the normal healthy function of cells.

H (Hypoxia): The inability of the body to deliver sufficient oxygen to the wound as a result of anemia, smoking, respiratory failure (or any other related disease) negatively impacts healing.

E (Extreme dryness): Dehydrated tissue (or, indeed, too much moisture) in a wound bed will keep cells from functioning properly.

A (Anemia): A lack of adequate red blood cells in the body can result in inadequate oxygen delivery and healing.