Which of the following is NOT a local factor affecting healing?

• A. Pressure
• B. Dehydration
• C. Edema
• D. Nutrition

Answer: (D)

Healing is shaped by factors at the wound site (local) and factors that come from the whole body (systemic). Local factors directly affecting the wound bed include pressure over the wound, which reduces blood flow and oxygen delivery; edema around the wound, which increases diffusion distance for oxygen and nutrients; and moisture balance that supports or hinders cell migration. Nutrition, however, is a systemic requirement. It supplies the proteins, vitamins, and minerals needed for collagen synthesis, immune response, and tissue repair, but it does not originate at the wound site itself. Adequate nutrition helps healing happen, even if local conditions are managed well, while poor nutrition can slow healing regardless of local factors.