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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.

L (Limited mobility): Patients who cannot move themselves often cannot relieve pressure on a wound or adjust their position to achieve optimal healing conditions.

So there you have it! Just remember “didn’t heal” and you’ll be able to investigate nine possible causes that might impact a wound’s progression.

(This content lightly adapted from Bardia Anvar, Mastery of Skin, Wound, and Ostomy Care, 2012).

Skilled Wound Care is a mobile surgical practice committed to transforming the chronic wound care model in nursing facilities. Wound care experts make weekly bedside visits to patients in long-term care facilities, avoiding transfers to hospitals or clinics. Our expert physicians give patients the most up-to-date and effective wound treatments, and educate facility staff on how to help patients continue to heal quickly and effectively between visits. This model of collaborative care allows SWC’s physicians to improve patients’ lives and health outcomes, to empower nursing staff, and to raise public awareness. Skilled Wound Care, along with its nurse and nursing home partners, is working every day to positively transform traditional nursing home wound care.

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