The Role of Nutrition for Pressure Injury Prevention and Healing: The 2019 International Clinical Practice Guideline Recommendations

Abstract

GENERAL PURPOSE To review the nutrition-related recommendations presented in the 2019 European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, and Pan Pacific Pressure Injury Alliance Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline with further discussion of nutrition for pressure injury management in the context of the recommendations. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant should be better able to: 1. Distinguish nutrition and malnutrition, especially as they relate to the development and healing of pressure injuries. 2. Differentiate the tools and techniques that help clinicians assess nutrition status as well as the causes of pressure injuries in specific populations. 3. Identify interventions for improving nutrition status and promoting pressure injury healing. ABSTRACT Macro- and micronutrients are required by each organ system in specific amounts to promote the growth, development, maintenance, and repair of body tissues. Specifically, nutrition plays an important role in the prevention and treatment of pressure injuries. The purpose of this manuscript is to review the nutrition-related recommendations presented in the 2019 European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, and Pan Pacific Pressure Injury Alliance Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline. Nutrition for pressure injury management is discussed in the context of the recommendations.

Selected Biochemical Blood Parameters and a Risk of Pressure Ulcers in Patients Receiving Treatment in Intensive Care Units

“…Malnutrition among hospitalised patients is still a common problem. It is estimated that 35–55% of patients admitted to hospitals are malnourished and approximately 20% of these require immediate nutritional therapy [ 4 , 10 ]. Monitoring of selected biochemical parameters as well as ongoing assessment of patients for a risk of pressure ulcers, with the use of recommended scales, contribute to decreased risk of pressure ulcers and complications [ 11 ].…”

“…Monitoring of selected biochemical parameters as well as ongoing assessment of patients for a risk of pressure ulcers, with the use of recommended scales, contribute to decreased risk of pressure ulcers and complications [ 11 ]. By implementing personalised nutritional care, it is possible to prevent the adverse effects of malnutrition, while early diagnosis of the problem should be considered among priority tasks to be handled by medical personnel [ 2 , 3 , 4 , 5 , 6 , 7 , 12 ].…”

“…Simple procedures designed to relieve the pressure, to change the position of the body and to keep the skin clean in practice are carried out on a daily basis. The process of maintaining adequate nutritional status through personalised selection of dietary energy supply as well as by the administration of enteral/parenteral feeding is a much more advanced model, requiring the cooperation of specialists in various disciplines [ 4 ].…”

Novas evidências científicas na assistência nutricional em portadores de lesão por pressão

“…As proteínas relacionam-se diretamente com o sistema imunológico e são integrantes dos tecidos corporais, além disso desempenham funções como marcadores diretos/indiretos de desnutrição, dentre as quais, podem ser mencionadas: albumina e pré-albumina, as principais, utilizadas para determinar o estado nutricional associado com demais marcadores antropométricos, bioquímicos, história alimentar e anamnese clínica em pacientes que são acometidos pelas consequências das LPP (Oliveira, 2017;Munoz et al, 2020).…”

Role of microRNAs in Pressure Ulcer Immune Response, Pathogenesis, and Treatment

“…For example, vitamin D deficiency has been shown to increase the risk of hospital-acquired pressure injury and the intake of high-protein nutritional supplements reduces pressure ulcer incidence in patients with terminal illnesses [66,67]. Among individuals who develop pressure injury, over 75% are malnourished, and the malnutrition can be secondary to undernutrition as well as obesity [68,69].…”