Then required time for the complete healing of chronic wounds remains extremely variable according to various clinical studies.
Nevertheless, it was observed that for certain wounds, this time is may be abnormally prolonged and despite of an
etiologic good wound management. In some chronic wounds, complete healing can never be achieved.
Factors which can "delay wound healing" have a negative effect on the evolution of the wound healing process and can lead to the risk of infection.. They can also be responsible for the deterioration of patient's quality of life and cause huge expenditure for the healthcare community.
A certain number of local and general factors have now been identified, which allow an understanding of which type of wounds may present with a risk of delayed healing and which patients present with unfavourable conditions which can also delay the healing process.
Delayed healing factors are factors which have been shown to have a negative influence on the wound healing process potentially delay it giving a poor outcome. These factors can be modified to varying degrees and can be defined in two categories:
- Factors associated with the condition of the wound: surface area, depth, location, age of the wound, recurrence, appearance of the wound bed (fibrin content > 50%, necrosed tissue content, presence of calcification), medical history (venous disease, DVT, varicose vein surgery, phlebitis, thrombosis, tissue hypoxia, arterial disorders (ABPI < 0.8), previous local treatments: lack of compression, inability to weight-bear, poor healing rate at 3-4 weeks.
- Factors associated with the patient: concomitant conditions (hip or knee surgery, poor joint mobility, ankylosis of the ankle, difficulty walking, oedema of the lower limbs, etc.), general condition of the patient (Peripheral Arterial Occlusive Disease (PAOD), poor nutrition (obesity / malnutrition), sedentarity lifestyle, poor hygiene, diabetes, immunodeficiency, etc.), age, sex.
But there are probably other factors, such as infection, non-concordance with previous treatment, depression.
