Selected Factors that Negatively Impact Healing

Wound healing is achieved through orchestrated phases that must occur in the proper sequence and time. Many factors impair normal healing by interfering with one or more of its phases. This chapter reviews the most important factors known to negatively affect healing and describes the mechanisms whereby they exert their detrimental effects. The factors discussed include patient-related factors (horse versus pony, age, nutritional status, disease, and tissue perfusion) and wound-related factors (causes and types of wounds, age and location of the wound, involvement of structures other than skin, nature of the wound, previous treatment, neoplastic transformation, and bioburden). A better understanding of the influence of these factors on repair may lead to a therapeutic approach that negates or diminishes their effects, thereby improving healing and resolving non-healing wounds.