Skin, Wounds and Nutrition Part 1

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Skin, Wounds and NutritionPart 1
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Skin Facts

• Largest body organ
• pH 4.2 5.6
• Normal flora
• Texture

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Function of Skin

• Protection
• Thermoregulation
• Sensation

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Risk Factors for Impaired Healing

• 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

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Wound Healing

• Anti-inflammatory agents
• Lathyrogens
• Age
• Nutrition
• Wound coverage
• Chemotherapy

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Wound Healing

• Infection
• Surgical technique
• Environmental temperature
• Denervation
• Radiation therapy
• Diabetes mellitus

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Five Major Components in the Healing Process

• Inflammation
• Cellular proliferation
• Connective tissue formation
• Wound contraction
• Wound remodeling

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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

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Wound Assessment

• Location, size
• Color, odor, texture
• Exudate
• Undermining

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Wound Assessment

• Eschar
• Granulation
• Wound margins
• Time in existence / treatment

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Venous Ulcers

• Characteristics
• Medial lower leg and ankle
• Hyperpigmentation
• Superficial
• Exudate

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Venous Ulcers

• Goal
• Increase venous return
• Decrease venous stasis / edema
• Wound environment
• Appropriate compression
• Treat perforators

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Arterial Ulcers

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

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Arterial Ulcers

• Goal
• Improve vascularity
• Protect
• Moisten
• Debride gently

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Yeasts and Fistulas

• Are an entirely different look

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