Nutrition and Chronic Wounds

Abstract

Nutrition is one of the most basic of medical issues and is often ignored as a problem in the management of our chronic wound patients. Unfortunately, malnutrition is widespread in our geriatric patients even in nursing homes in developed countries. Attention to basic nutrition and providing appropriate supplements may assist in the healing of our chronic wounds. Recent research has revealed the epidemiology of malnutrition in developed countries, the similarities to malnutrition in developing countries, and some of the physiologic and sociologic causes for this problem. More information is now available on the biochemical effects of nutrient deficiency and supplementation with macronutrients and micronutrients. In some cases, administration of isolated nutrients beyond recommended amounts for healthy individuals may have a pharmacologic effect to help wounds heal. Much of the knowledge of the nutritional support of chronic wounds is based on information that has been obtained from trauma management. Due to the demographic differences of the patients and differences in the physiology of acute and chronic wounds, it is not logical to assume that all aspects of nutritional support are identical in these patient groups. Before providing specific nutritional supplements, appropriate assessments of patient general nutritional status and the reasons for malnutrition must be obtained or specific nutrient supplementation will not be utilized. Future research must concentrate on the biochemical and physiologic differences of the acute and chronic wounds and the interaction with specific supplements, such as antioxidants, vitamin A, and vitamin D.

Malnutrition is independently associated with skin tears in hospital inpatient setting—Findings of a 6‐year point prevalence audit

“…Identification of modifiable risk factors for skin tears, such as malnutrition, is useful to highlight the need for the implementation of risk mitigation strategies (eg, manual handling precautions, dressing types), which may further contribute to improving patient care, preventing harm, and reducing health care costs. Nutrition is important for not only the prevention of skin tears but also its management, and nutrition should be optimised to heal any wounds, especially those that have developed into chronic wounds . Several studies state dietetic consultation as a beneficial strategy for skin tear prevention and management in order to promote and monitor adequate nutrition and hydration .…”

“…Nutrition is important for not only the prevention of skin tears but also its management, and nutrition should be optimised to heal any wounds, especially those that have developed into chronic wounds. 42 Several studies state dietetic consultation as a beneficial strategy for skin tear prevention and management in order to promote and monitor adequate nutrition and hydration. 8,25,28,36,43,44 This study further supports the role of nutrition in the prevention and management of skin tears.…”

Skin tears and risk factors assessment: a systematic review on evidence‐based medicine

“…In developed countries, especially in elderly patients, vitamin and nutritional deficiencies most commonly result from poverty, restrictive diets, medication, alcoholism and inadequate dietary intake. Recognition of early malnutrition status can be important for diagnosing underlying skin changes that could lead to skin tear formation (21,22,25). Serum albumin is a valid test of a patient's nutrition status.…”

“…The term malnutrition includes a variety of nutritional concerns, such as undernutrition, resulting from decreased or inadequate food intake; overnutrition caused by excessive food consumption; and specific nutrient deficiencies (21,22).…”

Pressure ulcer is associated with malnutrition as assessed by Nutritional Risk Screening (NRS 2002) in a mixed hospital population

“…Weight loss causes the body to go into a catabolic state, which has a negative impact on the healing process [32]. Disease-related weight loss is common, as about 70% of hospital patients are discharged with a lower body weight than at admission [18].…”