Table 3.

Effects of Smoking and Alcohol Abuse on the Healing Phases

	Inflammation	Proliferation	Remodeling
Smoking	Impaired leukocyte activity Decreased macrophages Decreased neutrophil bactericidal activity Decreased IL-1 products	Decreased fibroblast migration Decreased wound contraction Decreased epithelial regeneration Decreased extracellular production Increased proteases
Alcohol abuse	Decreased neutrophil chemokines with decreased neutrophil infiltration Decreased IL-8 and TNF-α Decreased monocyte function Decreased macrophage response to microbes	Decreased endothelial cell response Decreased angiogenesis Increased tissue hypoxia Impaired cell signaling	Decreased production of Type 1 collagen Increased level of MMP-8 Degradation of epithelial ECM Decreased tensile strength of skin