Infection – It prolongs inflammation and potentially increases the local tissue injury
Mechanical factors – early movements or increased local pressure or torsion may pull apart the wound
Foreign bodies – such as sutures or fragments of steel, glass or even bone can delay healing
Size & type of wound influence the healing – smaller wounds or surgical incisions may heal quickly than larger excisional wounds
Location of the injury and character of tissue is important
Wound on the skin covering the bone may heal slowly as little intervening tissue prevents wound contraction
In tissues like pleural or peritoneal or synovial cavities, inflammation develops extensive exudates which is later resorbed and fibrosis occurs
In absence of necrosis normal tissue architecture is restored
Systemic factors –
Nutrition –
Vitamint C deficiency inhibit collagen synthesis
Protein deficiency
Deficiency of trace elements like Copper and Zinc
Circulatory status – inadequate blood supply usually impairs wound healing
Metabolic status – Diabetes mellitus is associated with delayed wound healing because of microangiopathy
Hormones – such as Glucocorticoids inhibit collagen synthesis. Their administration may result in weakness of the scar due to inhibition of TGF-β production and diminishes fibrosis
Age – wound healing is delayed in old age when compared to young individuals
References
Vinay kumar, Abul K.Abbas, Nelson Fausto, Jon C. Aster. Robbins and Cotran Pathologic basis of disease. 9th edition.
Harsh mohan. Text book of Pathology.8th edition.2019