There are many factors that can influence and potentially impair the tissue repair process, including infection, diabetes, poor nutritional status, glucocorticoid use, mechanical factors, poor perfusion, foreign bodies, the extent and type of tissue injury, and the location of the injury. Infection in particular can prolong inflammation and increase tissue damage, impairing healing. Conditions like diabetes and poor nutrition can compromise healing through various mechanisms like inhibiting collagen synthesis. Glucocorticoids can reduce scarring but also decrease inflammation in some cases. Mechanical factors, poor blood flow, and foreign materials can also interfere with repair. The character of the injured tissue and location of the injury impact the repair process as well.

1. Factors That Influence Tissue
Repair

2.  Tissue repair may be altered by a
variety of influences, frequently
reducing the quality or adequacy of
the reparative process
 Extrinsic (e.g., infection)
 Intrinsic to the injured tissue
 Systemic or local

3. Infection
Is clinically one of the most important
causes of delay in healing; it prolongs
inflammation and potentially increases
the local tissue injury.

4. Diabetes
 Is a metabolic disease that
compromises tissue repair for many
reasons and is one of the most
important systemic causes of
abnormal wound healing.

5. Nutritional status
 Has profound effects on repair; protein
deficiency, for example, and
particularly vitamin C deficiency,
inhibits collagen synthesis and retards
healing.

6. Glucocorticoids (steroids)
Well-documented antiinflammatory effects,
and their administration may result in
weakness of the scar due to inhibition of
TGF-β production and diminished fibrosis.
In some instances, however, the anti-
inflammatory effects of glucocorticoids are
desirable.
 For example, in corneal infections,
glucocorticoids are sometimes
prescribed (along with antibiotics) to
reduce the likelihood of opacity that may
result from collagen deposition.

7. Mechanical factors
 Such as increased local pressure or
torsion may cause wounds to pull
apart, or dehisce.

8. Poor perfusion
 Due either to arteriosclerosis and
diabetes or to obstructed venous
drainage (e.g., in varicose veins), also
impairs healing

9. Foreign bodies
 such as fragments of steel, glass, or
even bone impede healing.

10. Type and extent of tissue injury
 Extensive injury will probably result in
incomplete tissue regeneration and at
least partial loss of function.
 Injury to tissues composed of
permanent cells must inevitably result
in scarring
 Such is the case with healing of a
myocardial infarct

11. Location of the injury
 Character of the tissue in which the injury
occurs are also important
 For example, inflammation arising in tissue
spaces (e.g. Pleural, peritoneal, synovial
cavities) develops extensive exudates.
 Repair occur by digestion of the exudate,
initiated by the proteolytic enzymes of
leukocytes and resorption of the liquefied
exudate.
 This is called resolution, and in the absence
of cellular necrosis, normal tissue
architecture is generally restored.

12.  In the setting of larger accumulations,
the exudate undergoes organization:
granulation tissue grows into the
exudate, and a fibrous scar ultimately