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Skin, Wounds and Nutrition Part 1

Skin, Wounds and Nutrition Part 1. Skin Facts. Largest body organ pH 4.2 – 5.6 Normal flora Texture. Function of Skin. Protection Thermoregulation Sensation. Advanced age Cognitive impairment/altered sensory perception Diabetes Inadequate perfusion/ oxygenation/circulation

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Skin, Wounds and Nutrition Part 1

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  1. Skin, Wounds and NutritionPart 1

  2. Skin Facts • Largest body organ • pH 4.2 – 5.6 • Normal flora • Texture

  3. Function of Skin • Protection • Thermoregulation • Sensation

  4. Advanced age Cognitive impairment/altered sensory perception Diabetes Inadequate perfusion/ oxygenation/circulation Impaired immunity Incontinence/moisture Infection Medications Malnutrition Obesity Preoperative illnesses/co-morbidities Underweight Risk Factors for Impaired Healing

  5. Wound Healing • Anti-inflammatory agents • Lathyrogens • Age • Nutrition • Wound coverage • Chemotherapy

  6. Wound Healing • Infection • Surgical technique • Environmental temperature • Denervation • Radiation therapy • Diabetes mellitus

  7. Five Major Components in the Healing Process • Inflammation • Cellular proliferation • Connective tissue formation • Wound contraction • Wound remodeling

  8. Components Inter-Related • Dependent on: • Adequate energy for cell proliferation, cell movement, and protein synthesis • Adequate protein, amino acids, and peptides for protein synthesis • Adequate micronutrients for metabolic activity • Adequate anabolic stimuli, in the form of growth factors and anabolic hormones

  9. Wound Assessment • Location, size • Color, odor, texture • Exudate • Undermining

  10. Wound Assessment • Eschar • Granulation • Wound margins • Time in existence / treatment

  11. Venous Ulcers Characteristics • Medial lower leg and ankle • Hyperpigmentation • Superficial • Exudate

  12. Venous Ulcers Goal • Increase venous return • Decrease venous stasis / edema • Wound environment • Appropriate compression • Treat perforators

  13. Arterial Ulcers Characteristics • Anywhere on leg/foot/toes • Painful • Dry eschar • Punched out • Skin shiny/light • No pulses

  14. Arterial Ulcers Goal • Improve vascularity • Protect • Moisten • Debride gently

  15. Yeasts and Fistulas • Are an entirely different look

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