Patient Factors That Affect Wound Healing

The patient's overall health status will affect the speed of the healing process. The following are factors that should

be considered by the surgical team prior to and during the procedure.

* 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 high dosages of catabolic