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Delayed wound healing: sometimes due to drug treatment

Some drug treatments slow down the healing process, especially if the wound is deep. These are best avoided if possible.

The speed of healing depends on the wound’s depth and how gaping it is. Slow healing sometimes results in severe complications: deep infection, further surgery to close the wound or if the wound reopens, slowness in the transplanted organ beginning to function, etc. Some complications can be life-threatening.

Several situations expose patients to slow wound healing: deficiency in some nutrients (proteins, vitamins, etc.); infections, some cardiovascular conditions, smoking, the regular consumption of large quantities of alcohol, radiotherapy, being bedridden, advanced age, obesity, diabetes. A compromised immune system is an aggravating factor.

Some drugs can delay wound healing: cytotoxic anticancer therapies and cytotoxic immunosuppressants (especially sirolimus); nonsteroidal anti-inflammatory drugs; corticosteroids, even inhaled; anticoagulants; bisphosphonates; local anaesthetics, etc.

If a wound is slow to heal, or becomes chronic, this could be related to the patient’s drug treatment. It might be necessary to stop any drugs known to delay healing, while taking into account the consequences of doing so on the patient’s health.

©Prescrire 1 April 2013

"Drugs that delay wound healing" Prescrire Int 2013; 22 (137): 94-98. (Pdf, subscribers only).
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