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- Role of nutrition in wound healing and nutritional recommendations for promotion of wound healing: a narrative review
- Myoungjean Ju, Yoonhong Kim, Kyung Won Seo
- Ann Clin Nutr Metab 2023;15(3):67-71. Published online December 1, 2023
- DOI: https://doi.org/10.15747/ACNM.2023.15.3.67
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Abstract
PDF - Purpose: Addressing both malnutrition and wound healing requires strategic intervention. However, guidelines for adequate nutrition for a variety of wounds are lacking. Based on the latest literature review, we summarize the role of nutrition in each stage of wound healing and nutritional recommendations for wound healing.
Current concept: Wounds undergo three healing phases: inflammatory, proliferative, and remodeling. The inflammatory phase involves clotting and cleaning the wound. The proliferative phase builds the wound bed through tissue growth. In the remodeling phase, collagen strength increases. Proper nutrition is crucial throughout. During inflammation, calcium, vitamin K, A, and E, zinc, and proteins are essential. In proliferation, amino acids, B vitamins, lipids, zinc, and iron play key roles. During remodeling, vitamins C and E, zinc, and water are critical for collagen synthesis and skin cell maturation. Vulnerable groups like the elderly, newborns, and obese patients need proper nutrition for skin maintenance. For pressure ulcers with malnutrition risk, recommendations are 30–35 kcal/kg/day energy, 1.25–1.5 g/kg/day protein, and 30 mL/kg water. Supplements might be added if regular meals don’t meet needs. For diabetic foot ulcers, despite common deficiencies, the 2019 International Working Group on the Diabetic Foot advises against prioritizing nutritional interventions over standard care due to limited high-quality evidence.
Conclusion: Despite limited guidelines, nutrition assessment is vital for wound evaluation. A multidisciplinary approach is key, emphasizing nutrition’s role in wound healing. Implementing nutritional interventions tailored to the wound and the individual’s nutritional status is essential. This comprehensive strategy ensures the best wound care outcomes.
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Original Article
- Analysis of the Factors Related to the Incidence and Aggravation of Pressure Ulcers for in Patients from a Nutritional and Clinical Perspective
- Yoon Young Choi, Han Mo Yoo, Young Hwa Kim, Jeong Goo Kim
- Surg Metab Nutr 2020;11(1):16-21. Published online June 30, 2020
- DOI: https://doi.org/10.18858/smn.2020.11.1.16
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Abstract
PDF
- Purpose: The incidence of pressure ulcers has reached significant proportions in ward patients. Considering the increasing proportion of older patients, it is important to know the factors associated with pressure ulcers. The purpose of this study was to investigate the association between nutritional status patients and the prognosis of pressure ulcers.
Materials and Methods: Four hundred patients who had their nutritional status evaluated from December 2015 to May 2016 at Daejeon St. Mary’s Hospital were enrolled in this study. The Modified NRS 2002 was used to address the nutritional status. Pressure ulcers were evaluated using the PUSH score, and the nutritional factors were evaluated with pressure ulcer aggravation.
Results: Among the 400 patients who had their nutritional status evaluated, 174 (43.5%) had a pressure ulcer. A high risk of malnutrition was associated significantly with the incidence of pressure ulcers. In patients with pressure ulcers, the necessity of a nutritional support team approach (odds ratio [OR], 2.43; 95% confidence interval [CI], 1.21∼4.91; P=0.01) and the number of pressure ulcers (odds ratio [OR], 3.79; 95% confidence interval [CI], 1.81∼7.91; P<0.001) were risk factors for pressure ulcer aggravation.
Conclusion: These results indicate that a proper evaluation of the malnutrition state and obtaining a nutritional support team intervention are important for preventing the aggravation of pressure ulcers. Furthermore, if a patient has multiple sites of pressure ulcers, a careful assessment will be needed to prevent their deterioration.
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