Proper wound healing depends on a patient’s ability to resist infection, to provide essential nutrients for use as building materials, and to carry out reparative cellularprocesses. Numerous medical conditions lmpalr :a
patient’s ability to resist infection and heal wounds. . These include conditions that establish a. Qtabolic state of metabolism, that impede oxygen or nutnent delivery to tissues, and that require administration of drugs or physical agents that interfere with immunologi( or wound-healing cells. Examples of diseases that induce a catabolic metabolic state Include poorly controlled  insulin-dependent diabetes mellitus, end-stage renalor
hepatic disease, and malignant diseases. Conditions that interfere with the delivery of oxygen or nutrients to wounded tissues include severe chronl.Cobstructive pulmonary disease (COPD). poorly compensated congestive heart failure (hypertrophic cardiomyopathy) and
addictions, such as ethanolism. Diseases requiring \ht administration of drugs that interfere with hot  trehses or wound-healing capabilities include autoimmune discrease  for which long-term corncosteroid therapy is given
and malignancies for which cytotoxic agents and irradiation are used.

T’he surgeon can help Improve the patient’s chances of ‘having normal heathy of  elective surgical wound by evaluating and optimizing the patient’s general health status before surgery. 11>[ malnourished patients, this include improving the nutritional status so that the patients is in  position  nitrogen balance and an anabolic metabolic state.

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