Burns are wounds. Wound healing is a complex process that can be affected by many factors. These factors may include:
- The age of the patient: elderly patients have delayed wound healing due to the fact that the blood supply is decreased to some parts of the skin with the presence of relative hypoxia (decreased oxygen). Very young and the elderly may not be able to mount an effective inflammatory response due to immature cells and less efficient physiological functioning respectively. See burns in geriatrics, Burns in pediatrics.
- Nutrition: nutrition plays an important factor in wound healing; patients who are malnourished have a decreased collagen formation. Wound healing requires protein synthesis therefore protein requirement increases in the presence of wound. Vitamins are also important for wound healing, vitamin C is important in collagen synthesis and in maintaining the immune function. Vitamin A is also important in promoting wound healing. zinc is important for wound healing as it's deficiency may impair wound healing, elderly are more liable for zinc deficiency due to poor intake and absorption. Zinc is important for many enzymes involved in the repair of tissue. Iron is important in collagen synthesis. Copper is also important as it's a co-factor for an enzyme called lysyl oxidase which is needed for cross linking of collagen molecules. See Nutrition and burns, Burns and fluid replacement.
- Infection: infection can affect wound healing and may lead to a delay or a non healing wound, infection has to be cleared before healing can take place. See Wound Infection, Burn wound care at home, Discharge home after a burn injury, Post hospital burn care.
- Presence of other illnesses: many illnesses can affect wound healing among which is diabetes. Diabetes affects the blood vessels leading to a change in the blood supply to the wound which in turn impair the delivery of oxygen and nutrients. Diabetes also affects the peripheral nerves leading to decreased sensation and a serious wound can result from a minor trauma. The wound of diabetic patients are more liable for infection. One of the other diseases that affect wound healing is malignancy in which the malignant cells grow very fast and nutrients are diverted from the wound side to the malignant cells. Loss of appetite and loss of weight in patients with malignancy also affect the healing of the wound. See Feet burns in diabetic patients.
- Medications: such as steroids which are anti-inflammatory that decreases inflammation and decreases the production of collagen, this will change the wound healing process and may delay wound healing.