Pressure ulcers are defined by the National Pressure Ulcer Advisory Panel as localized areas of tissue death that develop when tissue is compressed between a bony prominence and an external surface for a period of time. According to the Centers For Disease Control and Prevention, or CDC, in 2004 it was noted that more then one in every 10 nursing home residents across the United States had at least one pressure ulcer. Most pressure ulcers are preventable. However, once an individual develops one, interventions need to be taken immediately to slow the progression of the wound and promote healing. Proper nutrition can play an important role in the healing process, especially adequate protein intake.
Protein's Role in Wound Healing
Protein is responsible for the rebuilding and repairing of damaged tissue within the body. When the body does not get enough protein, it begins to break down muscle stores. People with pressure ulcers not only require enough protein to keep the body from breaking down their muscle mass, but in most cases, need additional protein to contribute toward healing the pressure ulcer itself. A wound may not heal if the individual is unable to meet his elevated protein needs. This increases the risk for developing an infection or another pressure ulcer.
Recommended Amounts of Protein for Pressure Ulcers
The amount of protein an individual with a pressure ulcer needs depends on her medical condition, overall nutrition status and the degree of tissue damage. This damage is typically assigned a stage or classification, ranging from 1, where the skin is intact, to 4, where bone, tendon or muscle is exposed and there is full thickness tissue loss. The more tissue damage, the higher the protein needs. General protein requirements for wound healing usually range between 1.2 g to 1.5 g of protein per kilogram of body weight, but may need to be increased or decreased depending on the individual's specific needs and plan of care.
Types of Protein
There are two main types of protein, high quality/complete proteins and incomplete proteins. Complete proteins contain all essential amino acids and usually come from animal sources, such as meats, fish, milk and eggs. Incomplete proteins may contain a few, but not all essential amino acids. Incomplete proteins are usually plant based foods such as legumes, nuts, seeds, grains and dark green leafy vegetables. When consuming a diet higher in incomplete proteins, such as a vegetarian diet, it is important to eat a variety of foods throughout the day to ensure adequate intake of all essential amino acids.
Good Sources of Protein To Promote Healing
In order to promote optimal wound healing, individuals with pressure ulcers should be encouraged to consume a diet higher in complete protein sources. Meeting elevated protein needs can often be challenging, and many people find eating smaller, more frequent meals and snacks easier to tolerate. Smoothies or milkshakes prepared with milk, yogurt or ice cream are helpful snack alternatives. Try adding peanut butter to toast or mixing beans with rice to make incomplete proteins more complete.
References
- National Pressure Ulcer Advisory Panel; Pressure Ulcer Stages Revised by NPUAP; 2007
- Center for Disease Control and Prevention; Pressure Ulcers Among Nursing Home Residents: United States: 2004; Park-Lee E. Ph.D, Caffrey C. Ph.D; Updated 2009.
- Today's Dietitian; New Recommendations for Treating Pressure Ulcers; Dorner, B. RD, LD; 2009
- Center for Disease Control and Prevention; Nutrition for Everyone: Basics: Protein; 2011.
