Nutrition-Lecture-revised-3-1-13.ppt.pptVIP

* * Simple sugars- found naturally in foods (milk/fruit) and added during refining and processing. Complex includes whole grains and foods with fiber (starchy veg, legumes, whole grains) * * * * * * Nutrition and Wound Healing Adequate intake of fat, carbohydrates and protein needed for wound healing to take place. Physiologic stress caused by wounds can increase need for dietary sources of conditionally essential amino acids (arginine and Glutamine) Encourage RDA recommendations for micronutrients. Consider MVI, vitamin C, Vitamin A and Zinc supplementation Nutritional drinks to help patients meet nutritional needs. Glucose control important with diabetics Nutrition Involvement in Wound Healing Vitamin A – enhances early inflammatory phase, promotes epithelial cell differentiation Protein– prevent prolonging inflammatory phase. Protein deficiency inhibits wound remodeling. Wound repair and immune function associated with glutamine and arginine supplementation. Vitamin C – enhances neutrophil migration and lymphocyte transformation, necessary for collagen synthesis, proper immune function and tissue antioxidant. Zinc – required for DNA synthesis, cell division, and protein synthesis Patients who cannot eat . . . ? Consider Nutrition Support! Nutrition Support Length of time a patient can remain NPO after surgery without complications is unknown, however depends on: Severity of operative stress Patient’s preexisting nutritional status Nature and severity of illness In uncomplicated cases, well nourished patients tolerate up to 10 days of starvation with no medical complications. Moderately or severely malnourished patients usually require nutritional support earlier.” (A.S.P.E.N Nutrition Support Practice Manual 2nd Ed) Goals of Nutrition Support post-surgery Decrease surgical mortality Decrease surgical complications and infection Reduce the catabolic state and restore anabolism Support the depleted patient throughout the catabolic phase of recovery Decr