THE PATIENT'S AGE--With aging, both skin and muscle tissue lose their tone and elasticity. Metabolism also slows, and circulation may be impaired. All of these factors lengthen healing time.
THE PATIENT'S WEIGHT--In obese patients of any age, excess fat at the wound site may prevent securing a good closure. In addition, fat does not have a rich blood supply, making it the most vulnerable of all tissues to trauma and infection. THE PATIENT'S NUTRITIONAL STATUS--Deficiencies in carbohydrates, proteins, zinc, and vitamins A, B, and C can impair the healing process. Adequate nutrition is essential to support cellular activity and collagen synthesis at the wound site. DEHYDRATION--If the patient's system has been depleted of fluids, the resulting electrolyte imbalance can affect cardiac function, kidney function, cellular metabolism, oxygenation of the blood, and hormonal function. These effects will not only impact upon the patient's overall health status and recovery from surgery but may also impair the healing process.
INADEQUATE BLOOD SUPPLY TO THE WOUND SITE--Oxygen is necessary for cell survival and, therefore, healing. Skin healing takes place most rapidly in the face and neck, which receive the greatest blood supply, and most slowly in the extremities. The presence of any condition that compromises the supply of blood to the wound, such as poor circulation to the limbs in a diabetic patient, will slow and can even arrest the healing process.
THE PATIENT'S IMMUNE RESPONSES--Because the immune response protects the patient from infection, immunodeficiencies may seriously compromise the outcome of a surgical procedure. Patients infected with HIV, as well as those who have recently undergone chemotherapy or who have taken prolonged...