Wound Healing

ABSTRACT

Wound healing is achieved through four coordinated and overlapping phases, 1) haemostasis, 2) inflammatory, 3) proliferative and 4) remodelling. This complex process can be disrupted by local or systemic risk factors, resulting in delayed healing and progression to a chronic wound. Chronic wounds interact closely with a patient’s comorbid illnesses, social circumstances and functional status. The Family Physician plays an important role to optimise patient and wound risk factors that impair wound healing. Strategies to enhance wound healing include optimising local wound care based on TIME principles, identification and optimising the underlying causes for poor wound healing and education to the patients and their caregivers in wound care, dressing changes and avoidance of risk factors to prevent recurrence. Complex chronic wound care may need a multi-disciplinary approach involving allied health members to provide additional nutritional, nursing and psychosocial support. There is a role for adjuvants such as hyperbaric oxygen therapy and platelet derived growth factor gels to enhance healing in certain wounds but stronger evidence is required to support its routine use.