Uraemia inhibits fibroblast activity, but how this occurs is not yet understood (Lawrence & Payne, 1984). McDermott et al. (1971) also found that epithelial cell division is depressed. Patients undergoing long-term peritoneal dialysis have a high wound complication following surgery which was seen to be related to poor nutrition and a high urea (Moffat etal, 1982). Barton and Barton (1981) found that a blood urea above 7 mmol/1 seriously delayed both granulation and epithelial-isation.

Incontinence, either urinary or faecal, causes problems of contamination in wounds in the perianal area. They are problematic to dress because of the constant soiling of the dressing.

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