B.W. did not say if he suffers with diabetes or high blood pressure, which is fairly common in his age group and which may adversely influence the ability of a wound to heal, as both conditions can be associated with circulatory insufficiency and, therefore, poorly healing wounds.

Diabetes, when uncontrolled, can also delay wound healing, as the germs love the sugar in the tissues and tend to flourish. Another condition associated with poor healing in the legs is bad varicose veins which also interferes with good circulation. These are conditions which should be screened for by a physician when poor wound healing is being experienced, and medication to improve the circulation and control high blood pressure or diabetes may be necessary before proper wound healing occurs.

What is also noteworthy is that diabetics, after a time, also tend to have diminished nerve sensation over the skin of the lower limbs, and have even been known to walk around unknowingly with a nail or sliver of glass in their foot bottom. They need to examine their feet often.

The risk of lockjaw, or tetanus, is very small if the person has been immunised against this disease. Tetanus is caused by clostridium tetani, is a germ found in the soil, in manure and in regular dirt. It enters the body through open wounds, particularly through puncture wounds of the type produced by a nail which are small and deep and restrict air entry to the wound.

The clostridium organism does not like air. Once in the body, clostridium releases a toxin which causes muscle spasms and severe muscle stiffness. The organism can be present from one day to about two weeks before the symptoms occur. The actual wound through which the germ entered the body may well be healed long before any symptoms occur.

Tetanus causes stiffness of the neck and jaw muscles and eventually stiffness over the entire body, which can eventually interfere with breathing. This is why when a puncture wound occurs a doctor should be seen and the wound properly cleaned and dressed.