Changes

remove/control and will inevitably have a harmful effect on healing.

remove/control and will inevitably have a harmful effect on healing.

Bacterial species (such as [[Pseudomonas aeruginosa and Burkholderia species|''Pseudomonas'']], [[Bacillus species|''Baccillus'']] or [[Proteus|''Proteus'']] as well as

Bacterial species (such as [[:Category:Pseudomonas and Burkholderia species|''Pseudomonas'']], [[Bacillus species|''Baccillus'']] or [[Proteus|''Proteus'']] as well as

some fungi) that produce collagenase (or other destructive) enzymes have

some fungi) that produce collagenase (or other destructive) enzymes have

a profound effect on healing by destruction of the collagen matrix, and so

a profound effect on healing by destruction of the collagen matrix, and so

* Excessive tension in the margins of the wound (often due to incorrect suturing techniques)

* Excessive tension in the margins of the wound (often due to incorrect suturing techniques)

* Accumulated exudate/dead space/pocketing

* Accumulated exudate/dead space/pocketing

* pH variations (usually alkaline). Ideally the pH of a wound should be around normal physiological pH or very slightly acidic (i.e. between pH 6.5 and 7.0). Alteration of the pH of a wound site is often a consequence of infection or wound dressings and solutions. A physiological state should be maintained as far as possible unless there are specific and defined reasons to alter this, for example, [[Pseudomonas aeruginosa and Burkholderia species|''Pseudomonas spp.'']] infection, where a more acidic environment will help control the bacterial replication.

* pH variations (usually alkaline). Ideally the pH of a wound should be around normal physiological pH or very slightly acidic (i.e. between pH 6.5 and 7.0). Alteration of the pH of a wound site is often a consequence of infection or wound dressings and solutions. A physiological state should be maintained as far as possible unless there are specific and defined reasons to alter this, for example, [[:Category:Pseudomonas and Burkholderia species|''Pseudomonas spp.'']] infection, where a more acidic environment will help control the bacterial replication.

* Poor surface oxygenation (this can be a result of dressings but more often is due to abnormal biofilms over the wound site that reduce surface gas exchange)

* Poor surface oxygenation (this can be a result of dressings but more often is due to abnormal biofilms over the wound site that reduce surface gas exchange)

* Low or high temperature

* Low or high temperature