Factors Affecting Wound Healing

0.8-1.5 mg/dL

Normal creatinine levels

3.5-5.5 g/dL

Normal serum albumin levels

16-40 mg/dL

serum prealbumin normal levels

>170 mg/dL

Serum transferrin levels

5-25 mg/dL

normal BUN levels

>1,800 cells/mm

Normal total lymphocyte (TLC)

70-110 mg/dL

normal blood glucose levels

Albumin

protein found in blood that is crucial in wound healing; low indicates liver disease, kidney disease, malnutrition, and/or burns. High indicates dehydration

BUN

indicated of renal function and fluid status; elevated is associated with delayed wound healing

Creatinine

byproduct of muscle metabolism; high levels indicates renal failure and negatively impacts wound healing

dehydration

if BUN increases while creatinine decreases, indicator of _____

Total Lymphocyte Count (TLC)

indirect measure of nutritional status and immune function, can indicate weakened immune system

high low

____ TLC indicates infection, inflammation, and certain cancers; ___ TLC is associated with poor wound healing, increased mortality, viral infections, autoimmune disorders, malnutrition, or medication related

5.7 9

normal hemoglobin is <____% and diabetic is >____%

30 40

doses of steroids > __-___ mg/day impair all phases of wound healing; suppress inflammation and immune response, decrease angiogenesis, decrease epithelialization, slow cells proliferation, decrease collagen synthesis and wound contraction, decrease tensile strength

dehydration

1% decrease in body weight due to fluid loss

30 35

recommended water intake in a healthy individual; ___-___ mL per Kg

30-35

with large or draining wounds, water intake should be ___-___ mL per Kg

amino acids

___ ____ are required for tissue repair and regeneration; involved in collagen synthesis, granulation tissue formation, angiogenesis, and remodeling. Low protein levels affect immune response and osmotic pressure

1.25-1.5 grams

recommended intake of protein per kilogram body weight

negative balance

body breaking down protein stores for energy

carbohydrates

provides energy for brain and blood cells; If there is not enough glucose, body will use fat/protein

fats

energy source once carbohydrate sources are depleted; assist in thermoregulation and protection, vital components of cell membranes

Vitamin A

vitamin; epithelial integrity, required for collagen synthesis, promotes granulation tissue formation, facilitates epithelialization, enhances macrophage function, can help counter effects of long term corticosteroid use

vitamin D

Vitamin; Immune function

Vitamin K

Vitamin; essential for blood clotting

Vitamin E

Vitamin; helps prevent free radical damage, decreases inflammatory phase, enhances immune function, decreases platelet adhesion

Vitamin C

Vitamin; needed to build and maintain tissue, required for collagen synthesis, activates and promotes migration of WBCs, antioxidant

B complex

Vitamin; a group of 8 water soluble vitamins, essential for normal immune function, energy metabolism, facilitate normal fibroblast function and collagen synthesis

Zinc

Mineral; vital to collagen and protein synthesis, assists in cell proliferation, epithelialization, assists in normal immune function, antioxidant

Iron

Mineral; essential component of HgB, needed for antibody production, Co-factor for many enzyme systems (collagen and DNA synthesis), can result in anemia (tissue hypoxia, decreased immune response, decreased cell replication, decreased tensile strength of wound

Copper

Mineral; required for HgB synthesis and iron absorption/transport , increased strength of collagen cross links

Magnesium

Minerals; Common in patients with DM, alcoholism, chronic diarrhea/dehydration, inadequate stores can lead to HTN and vasoconstriction

Calcium

Minerals; fibrin synthesis in blood clotting

Phosphorus

Minerals; normal metabolism, essential component of multiple enzyme systems

primary

immunodeficiency; defects in immune system classified by component of immune system that is deficient, absent, or defective; autoimmune conditions such as lupus, RA, IBS

secondary

immunodeficiency; metabolic or systemic disease; systemic disorders such as diabetes, malnutrition, HIV and immunosuppressive treatments such as chemotherapy, radiation therapy, chronic steroid use, critically ill patients

Humoral

deficiency in B-cell formation

Cellular

deficiency in T-cell formation

phagocytic

deficiency in phagocytic cells

4500 - 11000/mm3

Normal WBC count

Leukopenia

low WBC; caused by bone marrow disease, viral infection, chemotherapy

Leukocytosis

high WBC; caused by cancer, tissue injury, inflammation, infection - Sx include fever, somnolence, anorexia

Neutrophils

Most common WBC; first to fight infection

Neutropenia

neutrophil count too low; common with cancer and autoimmune disorders

Neutrophilia

neutrophil count too high

1500 per mL

normal neutrophil count

11-13.5 seconds

Normal PT/INR ratio

0.8-1.1

Normal INR