Table 3.

Local and systemic factors that impede wound healing

Local factors	Systemic factors
• Inadequate blood supply	• Advancing age and general immobility
	• Obesity
• Increased skin tension	• Smoking
• Poor surgical apposition	• Malnutrition
	• Deficiency of vitamins and trace elements
• Wound dehiscence	• Systemic malignancy and terminal illness
• Poor venous drainage	• Shock of any cause
• Presence of foreign body and foreign body reactions	• Chemotheraphy and radiotherapy
	• Immunosuppressant drugs, corticosteroids, anticoagulants
• Continued presence of microorganisms	• Inherited neutrophil disorders, such as leucocyte adhesion deficiency
• Infection	• Impaired macrophage activity (malacoplakia)
• Excess local mobility, such as over a joint