Pressure ulcers, sometimes called bedsores or decubitus ulcers, are both common and complex. According to 2009 information from the National Pressure Ulcer Advisory Panel, between 1 and 3 million Americans develop pressure ulcers each year, including between 2.3 and 28 percent of those in long-term care facilities. Additionally, around 60,000 Americans die from pressure ulcer complications each year. Stage 1 pressure ulcers are the least severe type; the skin is reddened but unbroken at the surface with possible changes in skin temperature and consistency. Active management of stage 1 ulcers can prevent further progression.
Increasing Calories
You may need extra calories in your diet if you have stage 1 pressure ulcers. Most people normally need around 25 calories per kg, or 2.2 lbs. of body weight. Calorie intake for patients with stage 1 pressure ulcers should equal between 25 to 30 calories per 2.2 lbs, the Minnesota Hospital Association suggests. Individuals under stress who may be using up more calories than usual may need 30 to 35 calories per 2.2 lbs., according to the National Pressure Ulcer Advisory Panel. Pressure ulcers occur more frequently in patients with body weight less than 58 kg, or 128 lbs.; low body weight and low calorie intake both increase the risk, Pierre Singer, M.D. of Tel Aviv University reports in the September 2002 issue of "IMAJ."
Increasing Protein
You normally need 0.8 g of protein per 2.2 lbs. of body weight, but if you have a stage 1 pressure ulcer, you may need extra protein to help heal damaged tissue. High protein intake can help speed healing. When you have a stage 1 pressure ulcer, your protein intake should fall between 1.25 and 1.5 g per 2.2 lbs. per day, the NPUAP recommends.
Adequate Fluid Intake
High protein intake may increase fluid needs. Drinking at least 8 to 10 glasses of water each day helps maintain good hydration. Watching for signs of dehydration helps ensure that fluid needs are met. Signs of dehydration include dry lips, decreased urine output, changes in weight or poor skin turgor. The Minnesota Hospital Association suggests a fluid intake of 30 ml, or 1 oz. of fluid per 2.2 lbs. per day, or a minimum of 1,500 ml, which equals 50 oz. per day, unless other medical conditions contraindicate.
Starting Enteral Feeding
If you can't consume enough calories to maintain adequate nutrition either because of lack of appetite, digestion problems, poor dentition, or difficulty chewing, feeding through a tube that goes directly into your stomach or small intestine may be necessary. Maintaining adequate nutrition is essential to prevent pressure ulcers from worsening.
References
- Minnesota Hospital Association; Nutrition Guidelines for Pressure Ulcer Management; January 2007
- National Pressure Ulcer Advisory Panel; The Role of Nutrition in Pressure Ulcer Prevention and Treatment; Becky Dorner, R.D., et al; 2009 ;
- "IMAJ;" Nutritional Care to Prevent and Heal Pressure Ulcers P; Pierre Singer, M.D.;
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