Why Isn’t My Wound Healing? #1 Dead Tissue on the Wound

Why Isn’t My Wound Healing? #1 Dead Tissue on the Wound

Nothing alive can grow over dead tissue.  If you have a large gash on your skin – for example, after hitting your leg on the sharp edge of the furniture — you may see your skin rolled to the side of the gash that later becomes dark.  This is dead skin that prevents wound healing.  Most wounds have some dead skin and soft tissue covering the wound bed.  By occupying the wound space, the dead tissue prevents new blood vessels, wound matrix and new skin from growing.  Also, microorganisms such as bacteria and fungus flourish eating dead tissue.  These bacteria and fungi can cause infection and delay healing.

When the dead tissue is small, our body can naturally remove it by sending cleaning white blood cells called “macrophages” that produce protein-melting cleaning solutions (proteolytic enzymes).  However, large amounts of dead tissue should be removed by other means to prevent infection and facilitate healing.  Removing dead tissue is called “debridement”.  For many non-healing wounds, debridement is usually the first step necessary to begin the healing process.

Debridement can be done with sharp instruments such as knives and scissors, ointments that have proteolytic enzymes, and even by medically produced maggots.  We use all above methods.  Medical maggots not only eat the dead tissue with computer-like precisions, but also produce wound healing chemicals.  So, when the decision is made to use maggots, please don’t be afraid.

Written by Dr. Byoung Yang