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Table 4. Factors Involved in Healing
Local Factors Systemic Factors
• Wound infection
• Bacterial colonization
• Ischemia
• Venous insufficiency
• Debris or foreign bodies
• Oxygen saturation
• Mechanical trauma / pressure
• Neuropathy
• Nutrient deficiencies
• Diabetes mellitus
• Renal disease
• Cardiovascular disease
• Advanced age
• Lack of mobility
• Smoking
• Certain medications
Hydration
• Hydration is essential since it helps regulate body temperature, maintains
kidney function, helps deliver nutrients to cells, contributes to good skin
turgor, and helps better blood flow, which are all important factors when
preventing and/or treating diabetic wounds.
• Hydration requirements can be 1 mL/kcal or standard maintenance fluid
requirements are 25–35 mL/kg of body weight/day for healthy adults.
• Before calculating estimated hydration needs consider the following:
▶ Heart failure
▶ Renal function
▶ Serum sodium values
▶ Dehydration
▶ Altered GI function (e.g., vomiting and/or diarrhea)
▶ Skin turgor
▶ Edema
▶ Hepatic cirrhosis
▶ Pharmaceuticals (e.g., corticosteroids, diuretics)
