Co-factors in impaired wound healing

Caring for individuals with chronic wounds is a complex process that requires a multi-disciplinary approach. Age, insufficient oxygenation/perfusion, malnutrition, bioburden, excess pressure, psychophysiological stress, concomitant conditions and adverse effects of treatment are the co-factors addressed in this manuscript. The evaluation of these co-factors is typically integrated into the initial history, physical, and ongoing assessment. Early identification of these co-factors allows the practitioner to establish a differential diagnosis, initiate proper referrals, and develop a comprehensive plan of care. Management of local and systemic co-factors that impact repair will mitigate their adverse effects and facilitate healing of the individual's chronic wound.