RAISED PLASMA LEVELS OF CORTICOSTEROIDS

The practitioner should always check to see if the patient is taking steroids, as this may result in raised plasma levels of the corticosteroids. Raised plasma levels of corticosteroids occurs in Cushing’s syndrome, steroid therapy, and psychological and emotional stress. Raised levels of corticosteroids suppress the inflammatory and immune responses and thus delay wound healing and reduce resistance to infection.

Corticosteroids also affect wound healing through a number of other mechanisms: antimitotic effects on keratinocytes and fibroblasts, decreased synthesis of extracellular matrix components and delayed epithelialisation (Levine, 2017).