People ask me all the time, "Why won't my wound close?"
And the answer is usually this: because something else is broken first.
Wound healing is like construction. You can't build anything without the right materials and the right workers.
If there's not enough blood flow, the wound can't get oxygen, nutrients, or immune support.
I always check to see if there's adequate circulation. If there isn't, we have to fix that before anything else.
A wound that doesn't have good blood supply is like a job site with no trucks, no tools, and no concrete. Nothing moves forward.
If you can't feel the wound, you keep injuring it. That's what happens with neuropathy.
The patient walks on the wound. Or it rubs inside a shoe. And it gets deeper and deeper without them even realizing.
So part of healing is protecting the wound — keeping pressure off, using the right shoes or devices, and making sure the patient understands what's happening.
Even with good blood flow and good offloading, wounds don't close unless the body has the energy and resources to build new tissue.
If you're malnourished or protein-deficient, your cells can't regenerate. That's why I always ask about diet and healing capacity.
If the bricklayer is there but you didn't deliver any bricks, the building doesn't go up.
Healing is a chain reaction. And if one link in the chain is broken — blood flow, sensation, nutrition — the wound stays open.
That's why I don't just look at the wound. I look at the whole person. Because fixing the wound without fixing the cause is just chasing your tail.