Factors That Interfere With Wound Healing
Factor | Examples |
|---|---|
Tissue ischemia (due to features of the wound or locally poor circulation) | Disorders affecting peripheral vasculature (eg, diabetes, arterial insufficiency) Type of injury (eg, a crush-type injury, which damages the microvasculature) Repair techniques (eg, overly tight sutures) Use of cautery |
Bacterial proliferation | Wound hematoma Foreign material (including deep dermal suture material) Delayed treatment (eg, > 6 hours for lower-extremity injuries; > 12 to 24 hours for face and scalp injuries) Significant wound contamination (as typically occurs in bite wounds) |
Drugs | Antiplatelet drugs and anticoagulants Drugs that suppress inflammation (eg, corticosteroids, immunosuppressants) |
Certain disorders | Disorders that suppress the immune system or impair healing (eg, chronic kidney disease) Undernutrition (eg, protein-calorie undernutrition, deficiencies of specific nutrients such as vitamin C) Disorders of collagen synthesis (eg, Marfan syndrome, Ehlers-Danlos syndrome) |