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7 Cards in this Set
- Front
- Back
Three phases of wound healing |
1. Inflammation and debridement 2. Repair/proliferation 3. Maturation |
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Inflammation and Debridement Phase Action of: - Macrophages initially - Neutrophils - Macrophages subsequently - Fibroblasts |
Migration of leucocytes into wound bed - Macrophages produce IL-1 to stimulate endothelial cells to make IL-8 to attract neutrophils - Neutrophils kill bacteria and degrade necrotic tissue - Macrophages produce fibronectin and growth factors that stimulate mitosis. Also phagocytosis of necrotic tissue. - Fibroblasts are stimulated to produce the matrix of granulation tissue NB: as wound becomes free of bacteria and necrotic tissue macrophage number decreases resulting in fewer cells being attracted. In chronic (+/- infected) wounds macrophages persist |
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Four processes in Repair/Proliferative Phase |
Angiogenesis (new capillaries) Fibroplasia (collagen production and change from type 3 to type 1) Wound Contraction (migration of myofibroblasts) Epithelialisation |
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screening tools for malnutrition - 4 points |
Recent weight loss, recent appetite, BMI and disease severity |
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When to institute nutritional support |
Anorexic for more than 3-5 days or hyporexic - 75 percent RER - for more than 7 days |
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Physiologic benefits of enteral nutrition |
Prevention of intestinal villous atrophy, maintenance of intestinal mucosal integrity - helps with prevention of bacterial translocation, and preservation of GI immunologic function |
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Refeeding syndrome Electrolytes Clinical signs |
Hypophosphatemia is the most common and critical electrolyte disturbance |