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Christopher J. Leonard, DO VP of Medical Affairs Vohra Wound Management.

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Presentation on theme: "Christopher J. Leonard, DO VP of Medical Affairs Vohra Wound Management."— Presentation transcript:

1 Christopher J. Leonard, DO VP of Medical Affairs Vohra Wound Management

2 Malnutrition globally translates to the cellular level Wound healing requires complex biochemical coordination Depletions of nutrients will impair wound healing Protein deficiencies will affect wound tensile strength Energy is required for the healing process

3 Food Availability Food Intake Nutrient Processing

4 Depression Dementia Cognitive Changes

5 Hyperglycemia Hypoxia Uremia

6 Visual Inspection and Physical Exam Cachexia Obesity (some data shows that morbid obesity had a stronger negative effect than cachexia on wound healing)

7 Verbal Nutritional History Weight Loss of 10% or greater within six months Weight Loss used appropriately within clinical scenario

8 Body Mass Index (BMI): weight (kg)/height (square meters) Percent Ideal Body Weight: Actual body weight X 100 divided by Ideal Body Weight Ideal Body Weight: For men is 106 lbs./5 ft. + 6 lbs./additional inch (+/- 10%), for women is 100 lbs./5 ft + 5 lbs./additional inch (+/- 10%)

9 Albumin (related to total body water, stress, nutrition) and half-life is 28 days Prealbumin (related to stress and nutrition) and half life is 72 hours Total Lymphocyte Count Transferrin

10 Complex Involves protein, carbohydrates, fats Stress states divert protein up to 30% away from a healing wound

11 Calorie Requirements Daily Protein Needs (assessment is complex) Carbohydrates and Fat Micronutrients

12 Zinc (enzyme cofactor) Copper and Iron (collagen and hemoglobin) Vitamin A (collagen and steroid issues) Vitamin C (collagen synthesis, common in elderly population) Glutamine (involved with gut metabolism and immune function)

13 Nutritional Screening Consultation with Registered Dietitian Patient Education/Dietary Instruction Meal Planning Nutritional Supplements Calorie Counts

14 Coordinated Efforts of Nutrition and Wound Care Nutritional Support Alone Not Adequate All Patients With Chronic Wounds Should Have A Nutritional Assessment

15 All patients with chronic wounds should have a nutritional screen All patients with chronic wounds who are deemed at risk for malnutrition should have a full nutritional assessment Nutrition is part of a complex process in wound healing, but only one component Base treatment on scientific evidence

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