NON-HEALING WOUNDS IN THE COLD WEATHER

Patients who come to our clinic always hear the Goldilocks principle for wound healing. Wounds can’t be too wet or too dry. They need the right amount of moisture to facilitate healing. When a wound loses moisture, the tissues will have a drop in temperature as well. Our body functions best at normal temperatures hovering around 37°C or 98.6°F. Whenever wound temperature drops at least 2°C, healing will slow and can even cease.

WHAT DOES COLD WEATHER DO TO WOUNDS?

1. Dry Skin

Cold temperatures and low humidity levels bring in dry air that draws moisture away from the skin leaving you with dry skin. The cold winter winds and dry indoor heat don’t help either as they only lead to your skin cracking and even bleeding.

Breathing in the cold dry air increases water loss because it needs to be warmed and moistened before reaching our lungs. Physical activities in the cold also increase fluid loss due to heavier and deeper breathing.

While dry skin is normal with aging, it may also be due to underlying illnesses like diabetes which makes the aged and diabetic people more prone to dry skin.

It is common for your lips to be more chapped during the cold months and the same goes with dry feet which can lead to cracks and open sores. Severe dry skin manifests with a feeling of tightness, roughness, flaking, itching, and redness which would need intervention otherwise it would lead to skin cracking open.

Noticing dry skin early and moisturizing it can help prevent new wounds and help existing wounds heal faster. Moisturize inside and outside with adequate hydration and supplementing with external moisturizers to help the skin battle cold weather.

What you can do?

• Moisturize internally and externally. Drink enough water to help the skin and the use of external moisturizers will keep the skin from losing moisture in the cold dry air.
• Avoid long hot showers or baths. Chills can feel like it’s deep within your bones making a long hot bath or shower very tempting but that exposure to hot water can also contribute to drying your skin and impeding wound healing. Try quick showers or baths in warm water instead followed by thoroughly patting dry with a towel. Then always moisturize after to retain skin hydration.
• Use a humidifier. Add humidity into dry environments to help dry skin and improve respiration. Heating systems can dry out air in rooms or a building, adding moisture is crucial for skin and respiratory health.
• Keep the wound covered with clean and dry dressings. Keep it wrapped, warm, and moist as moisture is needed for wound healing. Discuss with your wound care provider which moisturizers will work best for you and your wound.

2. Bacteria

Winter also brings in the cold and flu season wherein your immune system is working overtime to fight off bacteria and viruses causing illnesses, which will then leave your wound with less of your body’s healing cells and more prone to infection.

Wound infection interrupts the process of wound healing as bacteria in an infected wound cause cell death. Necrotic tissue prevents the growth of new tissue and it also serves as a culture for bacterial production leading to a chronic non-healing wound.

What you can do?

• Keep the wound dry and protected with bandages as directed. This will reduce the chance of infection and prevent transmission of infection.
• Avoid getting sick. This may sound next to impossible but taking precautions to decrease the chances of catching a cold or flu will help you and your healing. Consider getting an updated flu shot. Take Vitamin C and add more fruits to your diet to boost your immune system. Avoid large crowds and being around people who are already sick to avoid catching anything that will make your immune system work harder and decrease the healing allocated for the wound.

3. Decreased Blood Flow

Adequate blood circulation is essential to wound healing. Blood vessels supplying blood to the skin constrict or narrow in response to cold temperatures. This is called vasoconstriction which decreases blood flow to the skin as it helps minimize heat loss by pushing blood into the deeper tissues therefore preserving the normal internal or core temperature.

Cold weather worsens blood flow which will result in less oxygen to the wound making wounds more susceptible to bacteria and infection. Weak blood circulation to the extremities also restricts new tissue growth at the wound site.

What you can do?

• People normally stay indoors and “hibernate” to stay nice and warm during the cold season reducing the activity levels. However, it is ideal for people with diabetic ulcers to stay active as activity helps with blood circulation and wound healing.
• Keep the wound covered or wrapped when going out but be sure to not dress the wound too tight to reduce further decrease of blood flow. Keeping it covered will give it a warm and moist environment ideal for healing.
• Some winter-approved activities are indoor yoga and exercises you can do in the comforts of your home.

As we are having cold months, it is more important than ever to monitor and treat wounds. More often than not, people wait until a minor problem has become a major one before seeking medical treatment. If you know something is off, contact your wound care provider and get the treatment you need early on. We, wound care providers, work closely with patients to prevent wounds from getting worse and help them heal. We want those wounds healed as quickly as possible and avoid a trip to the ED or being admitted to the hospital.

Stay warm and cozy while keeping your skin moisturized. Non-healing wounds should receive the utmost care from your healthcare provider and more importantly, at home. 

Author

Jenna Wishnew Dr Wishnew is a Board Certified General Surgeon practicing in the North Texas area She specializes in general surgery, gastroparesis, wound care, vein concerns and robotic surgery.