Contraction, a reduction in blood supply to the site, and scar formation occur in the maturation phase, along with collagen turnover and reorganization. The wound loses mass while gaining resilience and strength. This phase lasts from months to years. It is interesting to note that tensile strength will never be the same as prior to wounding. There are a number of factors which impact wound healing.
Intrinsic factors are of internal origin and can include inadequate oxygenation.
Poor blood flow and wound oxygenation will not support granulation tissue production, affecting scarring and more severe loss of oxygenation to the wound, which can lead to increased risk of infection. Related issues include anemia or any similar manifestation. Malnutrition, infection or tissue damage significantly increases calorie and protein needs. The needs for Vitamins C, A, B, as well as the need for Iron, Copper, and Zinc are also increased. Concurrent disease, i.e., diabetes mellitus, immunosuppression, age, other systemic conditions such as liver failure, kidney failure, malignancies, edema, or inadequate hydration will also adversely affect wound healing.