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Delayed wound healing occurs when a wound or break in the skin takes longer than normal to heal. During cancer, delayed wound healing can occur because of changes to the skin, blood cells, blood vessels, and immune system.
For children with cancer, examples of wounds that might not heal properly include surgical incisions, pressure sores, device sites such as feeding tubes or central lines, and cuts or abrasions. Wounds that heal slowly can cause pain and discomfort, increase risk of infection, and even delay cancer treatments.
Wound healing occurs through a series of steps or phases. In general, these include:
The skin normally has a remarkable ability to heal itself. However, even when skin heals properly, the damaged or scarred area does not have the full strength of skin that was never injured.
Cancer treatments can often lead to slow or incomplete healing of wounds. Understanding how treatments may affect skin and healing can help families prepare for possible side effects and better manage wound and skin care.
Chemotherapy can cause a variety of side effects that affect the skin and its ability to heal. These include:
Effects of chemotherapy on wound healing depends on several factors such as the dose, frequency, duration, and timing of treatment. There may also be added effects if multiple drugs are used.
Radiation therapy can also slow wound healing, especially if the wound is near the treatment area. Radiation effects on skin include:
In general, higher or more frequent doses of radiation can lead to delayed wound healing.
Other cancer treatments, such as targeted therapy and immunotherapy, may also affect skin and wound healing.
The main goals of wound care are to keep the area clean, prevent infection, and nurture the skin so that it grows and heals. Wound care may include:
In some cases, patients may need surgery or other procedures to aid wound healing. Common procedures for wound care include wound debridement to remove dead tissue, surgery to repair tissue or close the wound, and negative pressure wound therapy (“wound vac”). The care team will discuss options based on individual patient needs.