week 10 & 11 Flashcards
What is the name of the hormone that controls hunger?
Leptin
What happens to white blood cells in obese people?
hypertrophy of WBC which produce hormones & chemokines -inflammation
how does obesity effect wound healing, at a cellular level?
wound contraction is decreased, keratinocyte migration is decreased, inflammatory cells stay in the wound for longer, poor quality granulation tissue, slower angiogenisis and altered collagen…
What can cause increased rate of infection in obese wounds?
neutrophils, require oxygen to perform wound cleansing role, longer operating times, increased tension on wounds.
What are radiation doses measured in?
rad and grey
what does 1 gray =?
100 rad
what should the total amount of treatments exceed (in rads)
6000 rads
how long can delayed changes in skin following radiation treatments last?
6-12 months
if performing surgery after radiation, how long must you wait to undergo surgery?
3 weeks
how long after surgery do you need to wait to have radiation?
6-8 weeks
What are some recommendations to manage skin post radiation?
wash with pH neutral soap, pat dry, hydrating creams, corn starch or talc to reduce friction, topical steroids (short time)
What does chemotherapy target?
proliferating cells.
The chemo drug Cyclophosphamide has what effect?
reduces initial vasodialation of inflammation and angiogenisis during proliferation
what does the chemo drug Thiotepa do?
inhibits fibroblasts and has an effect on tensile strength
what does the chemo drug Mechlorethamine (nitrogen mustard) do?
effects fibroblasts (wound healing strength) & delays proliferation of endothelial cells, poor quality granulation.
What is the aetology of Diabetes?
The body’s inability to normalize blood glucose.
What does high glycaemia and lipid levels do to cells?
inhibits the bodies ability to release cytokines
what do fibroblasts do in diabetics (wounds)
releases higher levels of pro-inflammatory cytokines
levels of what…. found in diabetic wounds decrease endothelial cell and lymphocyte proliferation?
nitric oxide
what do cells rely on to contract?
the conversion of fibroblasts into myofibroblasts
in summary, what are the main factors that affect diabetic wound healing?
cells reduced ability to synthesize and excrete growth factors.
when does a wound become chronic?
if it hasn’t healed by 8 weeks
what are some things that can be done to help heal a diabetic wound?
debridement, LLLT, ultrasound, dressings impregnated with collagen,
what are some factors that will influence wound healing…
oxygen, infection, narcotic tissue, capillary supply, wound bed, medications, co-morbidity, radiation/chemo, dressings, patient compliance.
