Bed Sores & Protein Intake

The Mayo Clinic describes pressure sores as occurring in patients of any age who sit for long periods in a wheelchair or who are bedridden, and who do not or cannot change position frequently. Prevention of pressure sores is a high priority, given that a report, published in 2006 by the Healthcare Cost and Utilization Project, notes that the overall incidence of pressure sores among American hospital patients in 2006 was over half a million, a 78.9 percent increase of the 1993 total of 281,300.

Development of Pressure Sores

Prolonged pressure, of just a couple of hours on skin covering bone, results in reduced capillary blood flow to the skin, and if ignored, results in tissue breakdown and an open sore. The most common sites are the sacrum and heels, although they can occur over other bony prominences, particularly if a patient is emaciated. In an article published in "American Family Physician" in 2008, Daniel Bluestein, M.D. et al. describe the first visible sign of a pressure sore as a reddening of the skin accompanied by discomfort and itching, which later darkens to a purplish color and eventually breaks down.

Prevention and Treatment of Pressure Sores With Dietary Protein

Elisabeth Mathus-Vliegen, M.D. cites the importance of protein and the vitamins C and D in the prevention of pressure sores in "The Journals of Gerontology Series A: Biological Sciences and Medical Sciences" in 2004, suggesting an optimum ratio of 1.5 g of protein per kg of body weight, with an overall ratio of 35 calories per kg. This is slightly higher than the Institute of Medicine's advised standard intake of 0.8 g of protein per kg for a healthy adult. However, the research was not successful in achieving consistent healing in patients using increased dietary protein once the skin had broken down.

Inconsistent Results of Dietary Protein Trials

Mathus-Vliegen's findings are in line with those published in 2003 by Gero Langer, MScN, et al. in "The Cochrane Database of Systematic Reviews," and by Bluestein et al. However, Langer et al. reported limited success with high and very high protein supplements, achieving a reduction in ulcer size of 42 percent and 73 percent respectively in a very small trial involving 12 randomly assigned patients. Ultimately, the researchers found that dietary protein was not consistently effective in the prevention and healing of pressure ulcers, even when combined with topical skin applications of moisturizer and vitamin C. Bluestein et al. suggest that the breakdown of skin is likely to be the result of a number of contributory factors and not simply the presence or otherwise of dietary protein, and that some pressure sores are inevitable.

New Developments in Treatment and Prevention

Despite these disappointing results, protein is nevertheless an essential factor in the health and viability of skin and underlying tissue, as it comprises essential and nonessential amino acids involved in cell production and renewal. S. Kwon Lee, M.D., et al. published breakthrough research findings in "Advances in Skin & Wound Care: The Journal for Prevention and Healing" in 2006, demonstrating that a highly concentrated form of collagen protein, an alternative to traditional forms of dietary protein, has a marked effect on pressure sore healing over several weeks. However, they cite the lack of and need for widespread research into the role of protein in the prevention and treatment of pressure sores, and the importance of further identifying the specific factors that produced their results.