Systemic factors:
(1) malnutrition
(1a) protein deficiency
(1b) deficiency in vitamins (A, C, K) and trace metals (Zinc)
(2) medications
(2a) corticosteroids
(2b) chemotherapeutic agents
(2c) anticoagulants
(3) endocrine disorders
(3a) thyrotoxicosis
(3b) Cushing's disease
(3c) poorly controlled diabetes mellitus (associated with complications)
(4) advanced age
(5) hereditary defects in collagen synthesis (Ehlers-Danlos syndrome, prolidase deficiency)
(6) fever
(7) cardiovascular
(7a) heart failure
(7b) peripheral vascular disease to site
(7c) systemic vasculitis
(8) respiratory disease with hypoxemia
(9) coagulopathy
(9a) hemophilia and other factor deficiencies
(10) cirrhosis (associated with complications)
(11) malignancy (associated with complications and therapy)
(12) heavy cigarette smoking
Local factors:
(1) incomplete debridement, with retained foreign material
(2) wound infection
(3) topical treatments with soft tissue toxicity
(4) physical manipulation of the wound
(5) extensive regional irradiation at the wound site
(6) edema
