Inflammation of the cellular tissue surrounding the wound is
(d) If pus collects in an already existing cavity such as the gallbladder
or lung, the term used is empyema.
(e) A fistula is an abnormal passage between two internal organs. A
wound which healed improperly could have caused this passage.
d. Anemia. In anemia, hemoglobin levels are lower resulting in tissue hypoxia
(abnormally low amount of oxygen in the body tissues). This changes collagen
synthesis and epithelialization, both functions in the healing process. The body
compensates by increasing blood circulation in a person with mild anemia.
If the volume percentage of red blood cells in the whole blood drops below 20 percent,
the lower oxygen tension in the tissues can disrupt local metabolism for cell
e. Immunosuppression. When a wound to the body occurs, inflammation is
the immediate response. Body tissue around the wound becomes red, swollen, a little
hot, sometimes painful, and sometimes there is a loss of function in that body part.
Immuno-suppression is a change, in a negative way, of the body's response to a foreign
substance. The body produces fewer, poorer quality leukocytes (white blood cells),
fewer immunoglobulins (proteins functioning as specific antibodies), or a lesser ability
for collagen synthesis. All of these are necessary for tissue repair.
f. Foreign Body in the Wound. A foreign body in a wound serves as a focal
point for infecting microbes or preventing tissue granulation (formation of small, fleshy
masses on the surface of a healing wound). Heart pacemakers and artificial legs, for
example, are necessary but also qualify as foreign objects that can harbor
microorganisms and cause infection. Sutures (stitches used in surgery to unite two
surfaces) also qualify as foreign substance and can be the source of infection. Sutures
which are too tight can also cause a wound to heal improperly; the sutures disrupting
the collagen network, compromising the tensile strength, and after the scab shrinks, the
final scar is wider than normal.
g. Blood Supply. Since blood supplies the products used in healing, any factor
which restricts blood circulation to a wound area interferes with healing. Dead or
edematous tissue, restrictive bandages, and damaged arteries can all slow the healing