Inadequate oxygenation Increased BMI Increased age Sex hormones: aged males have been shown to have delayed healing Psychosocial stress causing delayed healing Comorbidities, heart disease, TIA, and diabetes Glucocorticoids, immunosuppressants, and NSAIDs Chemotherapy and anticoagulants Alcohol consumption impairing wound healing Smoking impairing wound healing Deficiency of carbohydrates, proteins, vitamins A, B, and C, iron, zinc, copper, and magnesium | Infection and pus Necrotic tissue and foreign bodies Dry wound Mechanical stress on wound Cold environmental temperature Local oxygenation: this is decreased in peripheral vascular disease, previous radiation, inflammation, and diabetes mellitus |