cardiovascular disorders, malignancies and autoimmune disorders. Impeding factors Among other factors that may impede the healing of a wound are: patient's age obesity presence of infection poor nutrition or hydration prescribed medication substance abuse and smoking general effect of the wound on a patient's lifestyle (pain, wound odor, excessive drainage) Wound Wound cause If the wound is chronic, is it the result of: an underlying illness (diabetic, venous and arterial ulcers), poor handling of the patient (pressure injuries, deep tissue injuries, wounds with cavities and undermining), poor previous treatment choices that slowed down the healing (untreated infection, inappropriate wound care product choice, lack of necessary procedures). If the wound is acute, is it the result of: traumatic injury, burn, or surgery. Wound duration For chronic wounds: time the current wound has been present, is it a recurring wound, how many times it has recurred in the past, how long it took to heal each time. For acute wounds: when the wound was first acquired before the clinician visit. Wound state Wound bed, wound edge and periwound skin should be examined before the initial treatment plan is devised. It should also be re-assessed at each visit or each dressing change. For wound bed, the following parameters are assessed: Tissue type; presence and percentage of non-viable tissue covering the wound bed Level of exudate Presence of infection Wound edge must be examined to detect: Maceration Desiccation Undermining Elevation above surrounding tissue (raised edge) Epibole (rolled edge) For periwound skin, the following conditions should be diagnosed or ruled out: Maceration Dry, scaly skin Desiccation Excoriation and skin stripping Hypergranulation and hyperkeratosis Eczema Callus build-up and epibole Infection and inflammation References Healing Skin physiology