Bed sores, also referred to as pressure ulcers, are an area of localized damage to the skin and underlying tissue caused by pressure, shear force, friction, moisture or a combination of these, according to the text "Wound Practice and Research." Good nutrition plays a role in the prevention and treatment of pressure sores.
Wound Healing Stages
Wound healing occurs over three stages. The first phase is the inflammatory phase which starts at the time of injury. During this phase the blood vessels constrict and the clotting process begins. Leukocytes and monocytes, which are white blood cells, attack the injured area and remove bacteria and dead tissue. Following the inflammatory phase, the second phase is the proliferative phase. This begins within seven days of the injury. In this phase new blood vessels develop and help promote the growth of a protective tissue over the wound. About three weeks from the time of injury, the third phase also known as the remodeling phase begins. Wound edges are pulled inward and scar tissue forms.
Pressure Sores
When pressure is placed on bony prominences, such as the coccyx, buttocks, elbows or heels, blood flow is decreased to the area. When blood flow is decreased, that area of skin and tissue is deprived of oxygen. If friction or force occurs, intact skin can be disrupted. Skin is the first barrier in protection against infection. The combination of decreased blood flow and a disruption of skin increase the risk of pressure sores to develop.
Nutrition
Adequate calories, protein and fluid are necessary in preventing complications and promoting wound healing. Calories and protein supply energy for healing, and water is essential for cells to function normally. Carbohydrates are important in wound healing. The main carbohydrate is glucose, which is needed to start the removal of bacteria, dead tissue and promote cellular growth. As noted in "Critical Care Quarterly Nursing," two vitamins are of particular importance to wound healing: vitamin A and vitamin C. Vitamin A increases the strength of scar tissue and vitamin C helps repair collagen.
Complications
Patients with pressure sores and malnutrition are at a higher risk of developing infections. Without nutritional support, pressure ulcers can become chronic conditions leading to increased length of stay in hospitals, as well as increase morbidity and mortality rates.
Considerations
According to "Wound Practice and Research," the prevalence of pressure ulcers will escalate unless appropriate prevention, treatment and management plans are affected. The role of nutrition therapy in pressure ulcers is one area that offers promise.
References
- "Wound Practice and Research"; Nutrition Therapy in the Prevention and Treatment of Pressure Ulcers; Brockbank; May 2009
- "RN"; How To Help: Hogan: 2004
- "Critical Care Nursing Quarterly"; The Role of Nutrition in Wound Healing: Leininger; 2002
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