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the protein synthesis pathway.2122 Resolution of the hypercatabolic state and restoration of anabolic hormone activity is needed to help restore and maintain activity of the protein synthesis pathway, which is necessary for wound healing.

Hormonal Response to Wounding

As shown in Table 14.2, there are a number of key hormones involved with energy production, catabolism, and anabolism, all directly or indirectly affecting wound healing.6-9

The stress response to injury activated by any significant body insult, especially a large wound, leads to a maladaptive hormone response, producing an increase in the catabolic hormones cortisol and epinephrine. A decrease in anabolic hormones, growth hormones, and testosterone, also occurs (Table 14.3).6-9

The altered hormonal environment can lead to both a significant increase in catabolism, or tissue breakdown, and a decrease in the overall anabolic activity

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