-Vascular changes occur with increasing age, skin        is less pliable, and scar tissue is tighter.

    -For example, an older adult’s skin tears more               easily from mechanical trauma such as tape               removal.

Patient’s nutritional status
  -Tissue repair and infection resistance are directly       related to adequate nutrition.

   -Patients who are malnourished are at increased          risk for wound infections and wound infection-            related sepsis.

 -Patient’s size
   -Inadequate vascularization due to obesity will              decrease the delivery of nutrients and cellular               elements required for healing.

    -An obese person is at greater risk for wound               infection and dehiscence or evisceration.

 -Oxygenation
      -Factors such as decreased hemoglobin level,                smoking, and underlying cardiopulmonary                    conditions will decrease oxygenation.

      -Adequate oxygenation at the tissue level is                    essential for adequate tissue repair.

     -Hemoglobin level and oxygen release to tissues          is reduced in smokers.

-Patient’s medications
      -Steroids reduce the inflammatory response and        slow collagen synthesis.

      -Cortisone depresses fibroblast activity and                   capillary growth.

       -Chemotherapy depresses bone marrow                       production of white blood cells and impairs                  immune function.

-Chronic diseases or trauma

      -Chronic diseases and traumas such as diabetes         mellitus or radiation decrease tissue perfusion          and oxygen release to tissues.

Data source: Gallagher-Camden, 2012; Perry et al., 2014; Stotts, 2012

There are a number of things that can delay or complicate the healing of wounds, including: Diabetes mellitus. Low HGH (human growth hormone) Rheumatoid arthritis