Symptoms Of Poor Wound Healing And Stages Of The Process

May 6, 2024
A bandaged hand

Whether you are a professional athlete, weekend warrior, older adult, or just unlucky, injuries and wounds are a hassle to treat, and they can keep you out of the game for a while. When you have thin skin, diabetes, or a high-risk job or sport, wounds can be common and exposed to more trauma. Wounds are one of the most common medical injuries in athletes and non-athletes.

Typical Stages Of Wound Healing

Wound healing is a response to tissue injury. It involves a series of steps that gradually strengthen and heal the break in the skin.


Almost immediately after you sustain an injury that causes a break in your skin, small blood vessels surrounding the injury will constrict to reduce the bleeding. Next, platelets will clump and release chemicals that stimulate the healing process.

For larger wounds, you may need to help the blood vessel stop the bleeding by applying pressure to the wound.

Inflammation Or Scabbing

The inflammatory phase is intended to close the gap in your skin to reduce the risk of infection, but it does not restore skin strength.

Fibrin, a protein in the bloodstream, forms a scaffold across your cut. Platelets get caught in the scaffold and form a plug.

The inflammatory process will continue to bring immune cells to your cut and help the healing process. The signs of inflammation are:

  • Redness
  • Swelling
  • Pain
  • Warmth

Immune cells will remove pathogens and secrete chemicals called growth factors that speed healing. Increased blood flow is necessary during this stage, so you may see more redness and swelling.


Specialized cells called fibroblasts attach to the fibrin matrix and produce a nutrient-rich, sticky substance that draws the edges of the wound together and promotes healing.

Fibroblasts also produce collagen, a structural protein that strengthens the wound. Your body secretes collagen and gradually restores your skin strength for the next six weeks.


Even after the tissue is closed and repaired, it will continue remodeling. Your skin may have a shiny pink appearance and feel itchy as the healing process continues.

Blood supply is the key factor that will determine how fast and how well your wound will heal. Blood carries nutrients, oxygen, cells, and chemicals, which are essential for healing.

A wound on a person's leg

Redness And Warmth

Redness and warmth are normal during the initial phases of wound healing. These signs of inflammation indicate that immune cells are clearing dead and damaged tissue from the wound to get ready to repair it.

Inflammation after this initial phase may indicate infection. If you notice increasing redness, warmth, pain, and swelling in a wound that was healing or after the first few days, contact your doctor to see if it needs treatment. Infected wounds can become serious health issues if neglected.

Treatments for an infected wound will vary depending on the severity of the infection and your overall health but could include:

  • Cleaning the wound and removing damaged tissue
  • Applying antibiotic ointments
  • Taking an oral or intravenous antibiotic

Unpleasant Odor

An unpleasant odor usually indicates a bacterial infection or dead tissue. You may notice this, along with redness and swelling. Anaerobic bacteria emit an odor as part of their metabolic processes. Contact your doctor if you notice an unpleasant odor coming from your wound.

Increasing Pain

Pain, along with redness, swelling, and warmth, are signs of increased inflammation. While they can be normal early in the wound healing process, they are usually a sign of infection if they occur later. Unless you have an explanation for why your wound hurts more, contact your doctor to see if it is infected.

Skin Darkening 

Skin darkening on the edges of a wound can indicate that the tissue is not getting enough oxygen and is dying. Typically, this sign of tissue injury would come with pain, swelling, warmth, and other signs of inflammation or poor healing.

The edges should have a pink, shiny appearance as a wound heals.


Early in the healing process, your wound may have clear drainage. Plasma from the blood is light yellow. It may seep from your wound in its early stages. The fluid is thin and watery and may crust around the edges of your wound.

If the drainage becomes purulent, it is a sign of infection. Pus is a thick fluid made up of dead cells, bacteria, and tissue fluids. It typically has a foul odor and looks green or brown. Purulent drainage is usually accompanied by other signs of infection.   


Fever is your body’s response to infection and inflammation. If you have a fever, especially with other signs of infection, call your doctor immediately for advice. This may be a sign that the infection has entered your bloodstream.

Factors That Can Slow Wound Healing

Risk factors for poor wound healing include:

  • Smoking
  • Infection
  • Aging
  • Immobilization
  • Malnutrition
  • Blood vessel disease
  • Diabetes
  • Medications such as immunosuppressants

Most chronic wounds occur in people with diabetes. Decreased blood supply and sensation can cause pressure wounds. When would healing stalls, it could indicate a hard-to-heal chronic wound. Watch for these signs of poor wound healing.

Ways To Improve Wound Healing

The most important step you can take to improve wound healing is to keep it from getting infected.

  • Wash your hands with soap and water before treating your wound.
  • Remove any jewelry or clothing that may irritate your wound.
  • Apply direct pressure if the wound is bleeding.
  • Remove any foreign objects from the wound and rinse it with flowing water.
  • Keep your wound clean and dry.
  • Protect your wound from further injury.
  • Consume a healthy diet full of vitamins and antioxidants that support immune health.
  • If the wound is gaping, deep or unclean, it may be difficult to fully clean it at home. Bites and puncture wounds cannot be thoroughly cleaned. Seek medical care.
  • If your diet may be lacking, consider taking supplements, such as glutathione.
A bandaged wound

Chronic Wounds

Infection or poor blood supply usually causes chronic wounds. Chronic wounds can be classified as arterial ulcers, venous ulcers, diabetic ulcers, and pressure ulcers. These wounds should be cared for by your doctor to help prevent long-term tissue damage.

In the meantime, consume a healthy diet, drink plenty of water, rest the injured extremity, elevate it if there is any swelling, keep it clean, and apply antibiotic ointment. If you are a smoker, seek help with stopping. Chemicals in cigarette smoke constrict blood vessels, making it even harder for chronic wounds to heal.

Author: Leann Poston, M.D.
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