Nearly 60,000 U.S. hospital patients die every year from complications of pressure ulcers, reports the Institute for Healthcare Improvement. In 2007, the IHI estimated the total annual cost of pressure ulcer treatment in the US at $11 billion dollars. Nutrition plays a crucial role in the prevention and treatment of pressure-related wounds. According to the American Dietetic Association, nutrition therapy will help your wounds heal faster.
Pressure Ulcer Development
A pressure ulcer, also known as a bedsore, or decubitus ulcer, occurs when your skin is damaged from pressure or friction applied to one area for too long, says the National Pressure Ulcer Advisory Panel. Bony prominences, such as the tail bone, heels and hips are most susceptible to breakdown. Without proper treatment, the damage can progress from a suspected deep tissue injury, with a purplish area of intact skin, to a stage IV wound, with exposed bone, tendon or muscle. Advanced wounds are at risk for serious infection, which can be life-threatening.
Significance
The purpose of nutrition in the treatment of pressure ulcers, according to the ADA, is to facilitate wound healing, decrease risk of infection and maintain or replete nutrient stores. The National Pressure Ulcer Advisory Panel recommends that all individuals with a pressure ulcer see a dietitian and consume sufficient calories, protein, vitamins and minerals for wound healing. Adequate nutrition will help to prevent unintentional weight loss. One in five U.S. nursing home residents with weight loss had pressure ulcers in 2004, as reported by the Centers for Disease Control and Prevention.
Recommendations
If you have a pressure ulcer, consume between 30 and 35 calories per kg of body weight, more if you are underweight or have an infection, advises National Pressure Ulcer Advisory Panel. Protein intake of 1.25 to 1.5 g per kg will help to achieve a positive balance of nitrogen in your body, to facilitate wound healing. Consume a balanced diet that includes good sources of vitamins and minerals. If this is not possible, take a daily vitamin and mineral supplement. Try high-calorie and high-protein snacks or supplements to meet your needs, suggests the ADA.
Additional Nutrients
Consume adequate amounts of specific nutrients to support wound healing. The National Pressure Ulcer Advisory Panel recognizes vitamin C as important for tissue regeneration. Food sources include kiwifruit, oranges and red bell pepper. Zinc is an antioxidant mineral that supports cell proliferation. Seafood, meat, poultry and fortified cereals are good sources. Glutamine may function as fuel for cells that are critical to wound healing. The safe maximum supplemental dose of this amino acid is 0.57 g per kg of body weight per day.
Warnings
Before increasing your protein intake, check with your doctor to ensure that your kidneys are in good shape. Consume adequate fluids to prevent dehydration. The ADA recommends 30 to 35 mL of fluid per kg of body weight, or one mL per calorie ingested. Avoid over-supplementation of isolated nutrients. Long-term or high-dose zinc supplementation can adversely affect immune response and wound healing, cautions the ADA. High doses of vitamin C are known to potentially cause gastrointestinal upset.
References
- Institute for Healthcare Improvement: Relieve the Pressure and Reduce Harm
- National Pressure Ulcer Advisory Panel: Updated Staging System
- ADA Nutrition Care Manual: Short-Term Nutrition Therapy for People with Skin Breakdown
- NPUAP & EPUAP Pressure Ulcer Treatment Quick Reference Guide: Role of Nutrition in Pressure Ulcer Healing
- Centers for Disease Control and Prevention: Pressure Ulcers among Nursing Home Residents: United States, 2004
