Factors affecting wound healing

Abstract

Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutaneous wound healing and the potential cellular and/or molecular mechanisms involved. The factors discussed include oxygenation, infection, age and sex hormones, stress, diabetes, obesity, medications, alcoholism, smoking, and nutrition. A better understanding of the influence of these factors on repair may lead to therapeutics that improve wound healing and resolve impaired wounds.

Figure 1.

The effects of stress on wound healing. Stress-impaired wound healing is mediated primarily through the hypothalamic-pituitary-adrenal, sympathetic-adrenal medullary axes, and psychological-response-induced unhealthy behaviors.

Figure 2.

The potential effects of diabetes on wound healing. MMPs, matrix metalloproteases; ROS, reactive oxygen species; AGEs, advanced glycation end-products.