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

• A. Biofilm
• B. Age
• C. Circulation/Oxygenation
• D. Nutrition

Answer: (A)

Systemic factors influence wound healing across the whole body, shaping how effectively tissues repair themselves. Age matters because aging slows cell turnover and weakens immune responses, which can delay healing. Circulation and oxygenation are crucial since oxygen, nutrients, and immune cells must reach the wound; poor blood flow or hypoxia hampers collagen synthesis and fight against infection. Nutrition provides the raw materials and cofactors for tissue repair—adequate protein supports new tissue, while vitamins and minerals like vitamin C and zinc aid collagen formation and enzyme activity needed for healing.

Biofilm is a local, wound-site issue. It’s a community of bacteria that adheres to the wound surface and encases itself in a protective matrix, promoting persistent infection and inflammation at the site and thereby delaying healing locally. It does not reflect a body-wide (systemic) condition, which is why it’s not considered a systemic factor affecting healing.