ikkeheling

Ikkeheling is a Norwegian term used in medical contexts to describe the failure of tissues to heal normally after injury, surgery, or chronic disease. It covers situations in which healing is delayed beyond expected timeframes as well as complete lack of healing. Commonly, the term is applied to bone healing and to soft tissue wounds that fail to close.

In bone healing, ikkeheling encompasses delayed union and nonunion. Delayed union refers to slower-than-expected progression toward fracture consolidation, whereas nonunion describes a fracture that shows no significant progress toward healing over an extended period. In soft tissues, non-healing wounds or ulcers (such as diabetic, venous, or pressure ulcers) persist despite standard care.

Causes and risk factors include infection, inadequate blood supply, tissue necrosis, biomechanical instability at the injury site, malnutrition, diabetes, smoking, older age, chronic steroid use, and other comorbidities. Local factors such as foreign material, persistent edema, and necrotic tissue also contribute.

Diagnosis relies on clinical assessment and the timeframe since injury, imaging studies (X-ray, CT, MRI) to evaluate fracture healing, and, for wounds, wound measurement, microbiology cultures, and vascular assessment. Laboratory tests may be used to identify metabolic or infectious contributors.

Management focuses on addressing underlying causes and optimizing patient health. For fractures, treatment may involve stable fixation, bone grafting or substitutes, and, in some cases, bone stimulators. For non-healing wounds, evidence-based wound care, debridement, infection control, offloading, and vascular optimization are used; advanced modalities (negative pressure therapy, hyperbaric oxygen) may be appropriate in selected cases.

Prognosis varies with cause and treatment adequacy. Early identification and multidisciplinary care improve outcomes, while chronic non-healing conditions often require long-term management and monitoring.