Factors that can impede wound healing in patients
Natalie Marks, DVM, CVJ, CCFP, Elite FFCP-V, discusses how stress and comorbidities may impact wound healing, as well as factors to consider when deciding on the type of surgical closure
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Stress can negatively impact the immune system and wound healing, leading to increased inflammation and delayed recovery in patients. In an interview with dvm360 on her Fetch Kansas City conference lecture, Natalie Marks, DVM, CVJ, CCFP, Elite FFCP-V, talks about ways both external and internal stress can impede wound healing in patients. She also discussed factors to consider when deciding what type of wound closure to employ.
Below is a partial transcript:
Natalie Marks, DVM, CVJ, CCFP, Elite FFCP-V: We know from multiple studies that stress can impede the immune system, meaning depress it, as well as impede wound healing because of the way that the body then starts to allow more inflammatory cells to come in. If we have stress—whether that's in-hospital stress in a patient that's post op recovery, or we have chronic stress in the home that's impeding wound healing—we often, as veterinarians, don't take that into account.
Or there might be what I'm going to call ‘internal stress,’ ie, a comorbidity that's impeding wound healing; so maybe that patient is a diabetic or has Cushing's disease or previously had chemotherapy or has another disorder that either creates an environment where there's excessive cortisol—which of course, impedes wound healing—or has delayed wound healing because of another disease process, again, like diabetes. And if we don't take those factors into account when we're thinking about our repair or what we're going to have pet parents do at home, again, we often set ourselves up for failure, and we're giving the wrong expectation to the pet parent.
