Ask the Treatment Expert about... nutrition and wound healing
Rosalyn Jordan, RN, BSN, MSc, CWOCN, WCC
Are there any changes related to nutrition and wound healing we should know about?
Recently, I attended a national wound care conference and saw a renewed focus on nutrition in the wound care field. Research continues to indicate that malnutrition, or any imbalance in the food or fluid intake of an individual, may predispose that person to wound development or non-healing wounds.
Nutritional guidelines state that indications related to malnutrition are the loss of tissue including subcutaneous and/or muscle mass, weight loss that is not intended, energy intake that is not sufficient, fluid accumulation and decline in functional status.
Any condition that interferes with the nutritional intake of protein, vitamin and mineral requirements, obstructs impaired absorption, or results in inflammation promotes malnutrition. This inhibits wound healing.
Although clinicians have relied on lab values such as albumin and prealbumin as indications of nutritional status, they may not be adequate indicators of malnutrition. Current recommendations state that an individual who consumes fewer than 1,500 calories per day frequently ingests a deficient intake of vitamins and minerals. Consequently, close accurate monitoring and documentation of individual intake on a daily basis is essential.
Nutritional screening and assessment are imperative. These observations and documentation of findings should be performed on admission, when there is a significant change in condition, and if the wound is not progressing or healing. If there is a wound involved, a nutritionist or nutrition team should be consulted.
Protein, in particular, is essential for wound healing. A balanced intake of 30-to 35 kcal/kg body weight remains the recommendation. If there is a protein deficiency, protein supplements should be used.