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LOCAL AND SYSTEMIC FACTORS THAT INFLUENCE WOUND HEALING

The adequacy of wound repair may be impaired by systemic and local host factors.

Systemic factors include those listed below:
      Nutrition has profound effects on wound healing. Protein deficiency, for example, and particularly vitamin C deficiency, inhibit collagen synthesis and retard healing.
      Metabolic status can change wound healing. Diabetes mellitus, for example, is associated with delayed healing, as a consequence of the microangiopathy that is a frequent feature of this disease ( Chapter 24).
      Circulatory status can modulate wound healing. Inadequate blood supply, usually caused by arteriosclerosis or venous abnormalities (e.g., varicose veins) that retard venous drainage, also impairs healing.
      Hormones such as glucocorticoids have well-documented anti-inflammatory effects that influence various components of inflammation. These agents also inhibit collagen synthesis.

Local factors that influence healing include those listed here: