Asking a patient if they had a healthy meal isn’t just a matter of being polite. When it comes to wound care, it can mean the difference between a wound that heals, and one that may not.
Assessing a patient’s nutritional status is an important step in wound care. It’s estimated that up to one in three hospitalized adult patients are at risk for malnutrition.1 According to the World Health Organization, malnutrition refers to all forms of deficiency, excess, or imbalance in a person’s intake of energy and/or nutrients.2
Unfortunately, malnutrition is often difficult to diagnose, especially in hospital settings and for chronically ill patients where other symptoms may hide nutritional challenges. That means it’s up to the care team to look for symptoms such as poor appetite, lack of mobility, unusual fatigue, dry skin and a distended abdomen.
Net Health’s Chief Clinical Officer for Wound Care, Cathy Thomas Hess, BSN, RN, CWCN, is one of the pioneers in the study of wound care. Here are six nutrients she notes are critical for effective wound healing.
- Proteins. Proteins are an amazing nutrient, doing everything from maintaining cell growth to balancing fluids to helping with blood clotting. When it comes to wound care, proteins help support immunity while also assisting with the repair and synthesis of cells, as well as collagen and connective tissues.3
- Carbohydrates. Carbs not only provide the energy the body needs to heal, they also stimulate insulin production, which is helpful in the anabolic processes of wound healing.4
- Fats. As the most concentrated source of calories, fats provide a vital source of energy.5 Good fats (e.g., Omega 3 fatty acids in some fish, olive oil, nuts) support cell membrane structure and prostaglandin production.
- Vitamin A, C, E and K. These vitamins provide a number of benefits, including . . .
- Vitamin A helps collagen synthesis and epithelization, which contribute to wound closure.
- Vitamin C is important for membrane integrity and as an anti-oxidant.
- Vitamin E, among its many benefits, can help heal wounds infected with methicillin-resistant Staphylococcus aureus (MRSA).6
- Vitamin K is essential to the manufacture of clotting proteins and helps with coagulation.7
- Vitamin D. Vitamin D plays a critical role in two of the more challenging wounds to treat – venous and pressure ulcers8, and recent studies have identified vitamin D receptors in a variety of tissues where their presence was previously unknown. “Cathelicidin, an antimicrobial peptide induced by vitamin D, promotes wound healing.”9
- Fluids. Apart from calories, another factor of malnutrition to consider in wound healing is fluid intake. Fluids help with skin elasticity (poor elasticity is a sign of dehydration and/or poor nutrition) and much more, from oxygenation to waste removal. Work with caregivers, the nursing and dietary team to make sure fluid intake is carefully monitored.
The science behind the critical role nutrition plays in wound care continues to grow. It is a fascinating area of study. For example, other nutrients, including arginine, glutamine and zinc have recently been shown to play an important role in wound healing.10 Yet in some areas, like proper dosage for iron, there’s still a need for greater study. The key takeaway for anyone in wound care, is to pay attention to your patients’ nutritional profile and work with your entire team to make sure good nutrition is emphasized.
Nutrition is just one of the many ways to improve wound care healing. You can better track patients wound care status with Net Health’s WoundExpert®. Be sure to include nutrition information in the patient record to track status, better identify needs, and develop an actionable plan of care to help improve patient’s health status over time.
1,10The Journal of Parenteral and Enteral Nutrition. “Prevalence of Malnutrition Risk and the Impact of Nutrition Risk on Hospital Outcomes: Results from Nutrition Day in the US,” January 22, 2019
2World Health Organization Fact Sheet. “Malnutrition,” April 1, 2020
3Advances in Skin and Wound Care. “The Role of Nutrition for Pressure Injury Prevention and Healing: The 2019 International Clinical Practice Guideline Recommendations,” March 2020
4Wounds. “Nutrition in Wound Care Management,” December, 2015
5International Wound Journal. “Vitamin E and wound healing: an evidence-based review,” September 2020
6Indian Journal of Pharmacology. “Wound healing effects of topical Vitamin K: A randomized controlled trial,” March – April, 2019
8Tissue Barriers. “Vitamin D, vitamin D receptor and tissue barriers,” January 1, 2013
9Advances in Wound Care. Micronutrients, Arginine, and Glutamine: Does Supplementation Provide an Efficient Tool for Prevention and Treatment of Different Kinds of Wounds? November 1, 2014