You are asked to evaluate a patient with a vertical abdomina…

You are asked to evaluate a patient with a vertical abdominal wound after having a hemicolectomy for colon cancer. The surgery was 12 days ago.  The wound measures 15.0 x 2.5 x 5.6 cms.  The wound is 80% yellow slough and 20% granular.  There is minimal odor, no erythema, minimal edema.  There is moderate serosanguineous drainage on the dressings.  What is the biggest impairment (limitation) to wound healing for this gentleman?