Figure 5.

In the geriatric or chronically ill patient, there is a complex interaction between anorexia, infection, wounds, and metabolic needs. In a patient with marginal nutrition and a wound, infection (even if remote from the wound such as urinary tract infection) may increase metabolic demands and limit wound healing if the metabolic losses are not replaced. Such infections also commonly lead to more anorexia. The result is a vicious spiral potentially leading to the death of the patient if the cycle is not broken with appropriate interventions. With permission from WFUSM Plastic Surgery Collection.