Tissue Damage + Nutrients Flashcards
what are the 4 phases of wound healing
Homeostatsis
inflammatory
proliferation
remodeling
what happens during phase 1- homeostasis
- 5-10 min period of vasoconstriction followed by active vasodialation
- platlets within a fibrin clot secrete a variety of growth factors and cytokine
- Bradykins and prostaglandins lead to long term vasodilation
-fibrin plugs clot in the wound
What occurs in phase 2- inflammatory
-increase in vascular perm (migration of neutrophils and monocytes into surrounding tissue)
Order of WBC to reach wound in inflammatory phse
- polymorphonuclear leukocytes- first WBC to respond (begin phago)
- neutrophil migration ceases 1st few days post injury
- in late phase, monocytes convert to macrophages
What occurs in stage 3- proliferative
formation of granulation tissue and epitheiazation
- capilary growth
- chemotatic growth factors released from platelets and macrophages stim migration and activation of wound fibroblasts
- Collagen synthesis
What happens in phase 4= remodelling
- reorganization of collagen fibres
- contiues up to 2 years (achieving 40-70% strength @ 4 weeks)
How does Vit A influence wound healing + dosage
- epthelialization
- bone development
- cellular differentiation
- immune system function
–10 000 IU
(tox > 50 000)
what is zinc key for in wound healing
- important in action of collagenase*
- DNA synthesis
- Cell division
- Pro synthesis
- Processes for tissue regeneration + repair
What to keep in mind w supplementing EPA/DHA(fish oils) in wound healing
EPA can be antinflamatory
(increasing omega 3 fatty acids at wrong time may change ability of the inflammatory stage)
-but may be benificial in stage 3/4 when inflammation is no longer needed
how can vit c be good in wound healing
- only effective if pt has def*
- cofactor for synthesis of collagen
- procollagen translation increased
Protein in wound healing and amounts needed
traumatically injured pts are usually catabolic
1.5/kg may be adequate
>2/kg may be better
how many g of pro is MTOR pathway activated at
20-30g
how does curcurmin help wound healing
curcurmin targets NF-kB
-IL-1b inflammation and apoptosis inhibited
time response of the 3 nitric oxide syndthase isoforms and role in healing
Involved in tissue (tendon) healing
-increased thru L-arganine
inducible (INOS)- day 4
Endothelial (eNOS) - day 7
Neuronal (bNOS)- day 21
What is enhanced recovery after surgery + why
carb loading pre surgical client
- shorten hospital stay by decreasing post operative endocrine catabolic response and improving insulin resistence
What are the anesthesia concerns w enhanced recovery after sugery
- aspiration can result (if food is present in stomach during surgery
- done in= cholescystemctomy, colorectal surgery, hip replacement
What do Natural health products include
vit/mins herbal remedies homeopathic med traditional med probiotics
Natural health products must have what
- product licening
- site licensing
- GMP (good manufacturing process)
- Safety + efficacy
- Reviewal and approval process by HC
When is vit A a drug
vit A dose containing more than 10 000 iu
Vit K levels as a drig
sold for external use
or oral at .120mg or less
Vit D levels as a drug
more than 62.5-2500iu
l tryptophen levels for drug
more than 220mg per dosage
folic acid level for drug
containing more than 1mg per dose
nictotinic acid level for drug
provides 500mg or more per dosage unit
