Local disruptive elements

The selection of a suitable wound dressing is decisive for a successful healing process. Local factors which influence the healing process are the condition of the wound as well as the quality of the practiced wound management. The major factors are:   • Location of the wound: Is the wound in tissue with insufficient or sufficient blood supply or near the anus? • Condition of the wound base: Proportion of necrotic tissue, eschar, coatings, foreign bodies etc. • Condition of exudation: Bleeding, sanguineous-serous, purulent, dried out. • Extent of germ infestation/infection. • Age of the wound: Acute trauma, chronic wound condition. • Pressure and mechanical load in the wound area. • Condition of the wound margins: Maceration, edema, fissured. • Wound size and depth of the wound. • Local wound treatment: Use of the right wound dressing? • Temperature and moist wound environment.

Systemic disruptive elements

In patients with dementia, wound healing is often severely disrupted. The systemic influences result from the individually existing overall condition of the patient: Its relevance is marked to varying extents, so that some factors, such as vascular diseases or metabolic disturbances, can even trigger a wound themselves. • Age of the patient: Apart from physiological aging with its generally reduced cell activities, age-related multimorbidity can also delay wound healing. • Nutritional status and quality of nutrition. • Immune status: Immunodeficiency increases proneness to wound-healing impairments and infections. • Underlying diseases • Postoperative complications such as thrombosis, pneumonia, uremia etc. • Medication: Immunosuppressants, cytostatics, antiphlogistics and anticoagulants etc. have a negative effect on wound healing. • Psychosocial situation of the patient: The patient’s cooperation during wound management is important for successful treatment, which can be impaired by dementia, alcohol or drug abuse. • Dehydration back to overview