Section VII: CONTROLLING THE STRESS RESPONSE

One of the key aspects of management of the surgical patients is controlling the stress response.  Correcting the catabolic stimulus begins with minimizing tissue trauma and removing devitalized tissue.  Secondary stressors include pain and anxiety as well as infection.  Resistance exercise is critical as soon as possible.  Simple weight bearing is a significant resistance activity putting tension on the large muscles of the legs. 

Of course nutrition is a key component as well.  This anabolic strategy as well as the use of anabolic hormones, will be discussed next.