Which of the following are preoperative systemic factors that negatively affect wound healing?

All of the options listed have been recognized as preoperative systemic factors that can negatively impact wound healing. When considering the healing process, it is essential to understand how systemic health conditions and lifestyle factors can influence the body’s ability to recover after surgery.

Diabetes, for instance, complicates wound healing due to potential blood flow issues and impaired immune response. Elevated blood sugar levels can also lead to delayed wound healing and an increased risk of infection.

Protein deficiency is another critical factor, as protein plays a crucial role in tissue repair and regeneration. Inadequate protein levels can hinder the synthesis of collagen, which is essential for wound healing. This deficiency impairs the body's ability to respond to injury effectively.

Smoking negatively impacts oxygen delivery throughout the body. It constricts blood vessels and reduces oxygen and nutrient flow to the surgical site, which is vital for healing. Smokers also face an increased risk of postoperative complications and slower recovery due to impaired blood circulation.

Combining these factors indicates that they all contribute to a compromised healing process, which is why the answer encompassing all of them is indeed correct.