“Why is my wound not healing?” This is a deceptively simple questions that is usually tied to complex underlying medical co-morbdities, which get in the way of the coordinated series of events leading to wound closure. As a patient becomes more medically complex so does their medical management, and as a result their medication lists balloon.

Medications, particularly in the wound care patient are a key component in the history gathering process. Exposure to certain classes of medications can lead to impaired wound healing or are directly implicated in wound causation. As a recent example the FDA issued a warning about the risk of amputation with concurrent use of Canagliflozin (Invokana,Janssen) a newer drug in the sodium-glucose cotransporter 2 inhibitor (SGLT2). Hydroxyurea is another common drug that I see in the clinic that can potentially cause ulcers. JAMA Dermatology has a great series on hydroxurea associated ulcers here.

Other drugs implicated in poor wound healing include NSAIDs, corticosteroids, chemotherapy agents, colchicine, antiplatelet agents, topical antiseptics, vasoconstrictors. For a good comprehensive review of drugs that effect wound healing as well as the mechanisms by which they effect a wound,check out this CME activity by Wound Management.