Why Do Wounds Heal Slowly?

caulocare
Jun 16
4 min read

A Comprehensive View from Western Medicine, Traditional Chinese Medicine, Biochemistry, and Anatomy

Dr. Phumlarp Caulo| Caulo Care | Fores Hills, New York| June 16, 2025

🩸 Introduction

Have you ever noticed that some wounds refuse to heal? Days pass, and the cut remains — inflamed, tender, or simply static. In medical science, wound healing is not just a matter of time. It reflects the harmony or imbalance of multiple systems, from your immune and circulatory responses to subtle energy flow and nutrition.

In this article, we explore the science behind slow wound healing through five lenses: modern medicine, pioneering researchers, Traditional Chinese Medicine (TCM), biochemistry, and anatomy & physiology (AP).

🧬 1. Modern Medicine: The Four Phases of Wound Healing

In Western medicine, wound healing is a complex biological process consisting of four main phases:

1.1 Hemostasis (Stopping the Bleeding)

Initiates immediately after injury.
Platelets aggregate at the wound site.
They release clotting factors and trigger the formation of a fibrin clot to seal the wound.

1.2 Inflammation (Immune Defense)

Occurs during the first 1–3 days.
Neutrophils and macrophages arrive to destroy pathogens and remove dead tissue.
These immune cells release cytokines that signal the next phase.

1.3 Proliferation (Tissue Regrowth)

Begins around day 4–21.
Angiogenesis creates new blood vessels.
Fibroblasts produce collagen and extracellular matrix.
Keratinocytes migrate to cover the wound.

1.4 Remodeling (Maturation and Strengthening)

Starts around week 3 and can last months to years.
Collagen transitions from Type III to Type I.
The wound gains tensile strength but never regains 100% of its original skin integrity.

Factors That Delay Healing:

Diabetes (poor circulation)
Chronic infection
Nutritional deficiencies (protein, vitamins C, A, zinc)
Stress, poor sleep, and smoking
Steroid or chemotherapy drugs

🧠 2. Pioneers in Hemostasis Research

Understanding hemostasis was not a single discovery but an evolution over centuries led by several brilliant minds:

2.1 William Hewson (1739–1774)

Known as the Father of Hematology.
First to describe the formation of fibrin during blood clotting.
Discovered how fibrin fibers trap red and white blood cells to form a stable clot.

2.2 Giulio Bizzozero (1846–1901)

Italian pathologist who discovered platelets.
Identified their crucial role in blood clotting and aggregation at wound sites.

2.3 Paul Morawitz (1879–1936)

Developed the early Coagulation Cascade theory.
Identified four key clotting components: fibrinogen, prothrombin, thrombokinase, and calcium.
Laid the groundwork for the future classification of coagulation factors.

2.4 The Modern Era: Naming Coagulation Factors

In the 20th century, researchers like Dr. Oscar Ratnoff and Dr. Earl Davie furthered this work.
They helped establish the modern list of Coagulation Factors I–XIII.

🌿 3. Traditional Chinese Medicine (TCM) Perspective

From the lens of Traditional Chinese Medicine, delayed wound healing is often associated with internal imbalances involving Qi (vital energy) and Blood:

3.1 Qi and Blood Deficiency

Qi drives the healing process; Blood provides the nourishment for tissue repair.
Deficiency leads to fatigue, pallor, and wounds that are dry or slow to regenerate.

3.2 Damp-Heat and Heat Toxins

If the wound is infected, swollen, odorous, or oozing, it is often attributed to heat toxins and dampness obstructing healing.
These block the circulation of Qi and Blood, impeding recovery.

3.3 Liver and Spleen Dysfunction

The Spleen is responsible for producing Blood and Qi; a weak spleen leads to insufficient repair material.
The Liver governs the smooth flow of Blood; if Liver Qi is stagnant, circulation to the wound is impaired.

⚛️ 4. Biochemical Perspective

4.1 Key Nutrients in Wound Healing:

Protein: Essential for collagen and tissue formation.
Vitamin C: Required for collagen hydroxylation.
Vitamin A: Promotes epithelial regeneration.
Zinc: A vital enzyme cofactor in wound repair.
Iron: Supports red blood cell formation and oxygen delivery.
Omega-3 fatty acids: Reduce chronic inflammation and support repair.

4.2 Critical Cytokines and Growth Factors:

EGF (Epidermal Growth Factor): Stimulates skin cell proliferation.
VEGF (Vascular Endothelial Growth Factor): Promotes blood vessel formation.
TGF-β (Transforming Growth Factor-beta): Regulates extracellular matrix deposition and remodeling.

🫀 5. Anatomy & Physiology (A&P)

5.1 Systems Involved in Wound Healing:

Circulatory system: Delivers oxygen, nutrients, and immune cells to the wound.
Lymphatic system: Removes waste and pathogens.
Skin structure:
- Epidermis: Outer protective layer
- Dermis: Primary repair zone (collagen, blood vessels)
- Hypodermis: Connective fat tissue layer

5.2 Anatomical Barriers to Healing:

Wounds on low-circulation areas (e.g., feet, toes) heal slowly.
In elderly patients, reduced capillary density and fibroblast activity delay repair.
Constant pressure (e.g., bed sores) impedes blood flow, leading to pressure ulcers.

🧾 Conclusion

Wound healing is not a passive process. It is the result of precise biological coordination, internal balance, and external care. Whether viewed through the lens of molecular biology, ancient healing philosophies, or the human anatomy, delayed healing is always a sign to look deeper.

Understanding these mechanisms empowers both practitioners and patients to take proactive steps—nutritionally, emotionally, and energetically—to promote healing from within.

Dr. Phumlarp Caulo LAc,MsAc,OM,DAHM,Pre-RN

Integrative Medicine Practitioner, bridging Eastern and Western Wisdom.

“Rooted in ancient wisdom, guided by modern science

On this page, we look back at history so you can move forward with health.

I believe in Mother of the Earth, the timeless healer of body and soul.”

This information is only educational and should not be construed as medical advice.

Everything must be balanced, and the suggestions may not apply to you.

A specialist doctor should be consulted for any medical advice or diagnosis.

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Dr. Phumlarp Caulo LA,c, MAc. OM, DAHM