Factors Affecting Healing Potential

Local <---------------------------------------------------------> Host <------------------------------------------------> Environment

• Necrosis
• Infection
• Pressure injury on the ulcer area Micro-vascular supply
• Foreign body
• Iatrogenic/cytotoxic agents
• Local trauma to ulcer area

• Co-morbidities:

• End-stage renal disease
• Immunosuppression
• Inflammatory condition
• Visual impairments
• Glycemic control
• Nutrition
• Peripheral arterial disease
• Venous insufficiency
• Lymphedema
• Coronary artery disease
• Obesity

• Systemic cytotoxic drugs
• Smoking
• Alcohol and substance use
• Adherence to plan of care
• Cultural/personal beliefs
• Mental illness (schizophrenia, depression)
• Cognitive impairment
• Low socioeconomic status
• Concordance to plan of care

• Access to care
• Access to appropriate offloading
• Family support
• Health-care sector
• Geographic surroundings
• Socioeconomic status