Poor Wound Healing is Directly Related to Dialysis: What You Need to Know

If you are on dialysis, you may have a higher risk of developing wounds that are hard to heal. Wounds can be caused by many factors, such as diabetes, peripheral artery disease, pressure ulcers, infections, or injuries. Wounds can affect your quality of life, increase your risk of complications, and lead to hospitalizations or amputations. Therefore, it is important to understand how dialysis affects wound healing and what you can do to prevent and treat wounds.

How Dialysis Affects Wound Healing

Dialysis is a life-saving treatment that removes waste and excess fluid from your blood when your kidneys are not working well. However, dialysis also has some side effects that can impair wound healing, such as:

  • Altered metabolism of nutrients that are essential for wound healing, such as zinc, arginine, and vitamins A and C. These nutrients help with collagen synthesis, inflammation control, and immune function. However, kidney failure, dialysis, and dialysis-related medications can affect their absorption, utilization, and excretion.
  • Increased risk of infection due to a weakened immune system and frequent exposure to bacteria through dialysis access sites or catheters. Infection can delay wound healing and cause tissue damage or sepsis.
  • Reduced blood flow to the extremities due to peripheral artery disease or calciphylaxis. Peripheral artery disease is a condition where the arteries that supply blood to the legs and feet become narrowed or blocked by plaque. Calciphylaxis is a rare condition where calcium deposits form in the small blood vessels of the skin and fat tissue, causing painful ulcers and gangrene. Both conditions can reduce the oxygen and nutrient delivery to the wound site and impair healing.

How to Prevent and Treat Wounds on Dialysis

The best way to prevent wounds on dialysis is to take good care of your overall health and follow your doctor’s recommendations. Some general tips include:

  • Control your blood sugar levels if you have diabetes. High blood sugar can damage your nerves and blood vessels, leading to diabetic foot ulcers or infections.
  • Check your feet daily for any signs of injury, infection, or skin breakdown. Wear comfortable shoes that fit well and protect your feet from trauma. Avoid walking barefoot or wearing tight socks or stockings .
  • Keep your skin clean and moisturized. Avoid scratching or rubbing your skin too hard. Use mild soap and water to wash your skin and pat it dry gently. Apply lotion or cream to prevent dryness or cracking.
  • Avoid pressure on your skin, especially if you have limited mobility or cognitive impairment. Change your position frequently and use pillows or cushions to relieve pressure on bony areas. If you have a pressure ulcer, follow your doctor’s instructions on how to dress and care for it.
  • Keep your dialysis access site clean and dry. Follow the instructions on how to care for your fistula, graft, or catheter. Report any signs of infection, such as redness, swelling, pain, pus, or fever, to your dialysis team .

If you have a wound on dialysis, you may need additional treatment to help it heal faster and prevent complications. Some possible treatments include:

  • Nutrition therapy. You may need more protein in your diet to support wound healing. Protein helps with tissue growth and repair and also prevents muscle wasting. The recommended protein intake for dialysis patients with wounds is 1.25-1.5 grams per kilogram of body weight per day. You may also need supplements of zinc, arginine, or vitamins A and C if you are deficient in these nutrients. Your dietitian can help you plan a balanced diet that meets your nutritional needs.
  • Wound dressing. You may need a special dressing that protects your wound from infection and promotes healing. There are different types of dressings available, such as gauze, foam, hydrogel, hydrocolloid, alginate, or silver. Your doctor or nurse will choose the best dressing for your wound based on its size, depth, location, and drainaga.
  • Debridement. You may need to have dead or infected tissue removed from your wound to improve healing. Debridement can be done by using scissors, scalpel, forceps, enzymes, maggots, or ultrasound.
  • Revascularization. You may need a procedure that restores blood flow to your wound if you have peripheral artery disease or calciphylaxis. Revascularization can be done by using angioplasty (balloon dilation), stenting (metal mesh insertion), bypass surgery (grafting a new blood vessel), or endarterectomy (removing plaque from the artery).
  • Skin grafting. You may need a surgery that transfers healthy skin from another part of your body to cover your wound if you have a large or deep wound that does not heal with other treatments. Skin grafting can help reduce pain, infection, and fluid loss and improve the appearance of your wound.

Conclusion

Poor wound healing is directly related to dialysis and can affect your health and quality of life. However, you can prevent and treat wounds on dialysis by following a healthy lifestyle, taking care of your skin and feet, and seeking medical attention when needed. By doing so, you can improve your wound healing outcomes and reduce your risk of complications.

Doms Desk

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