Chronic Wounds and the Effect of Poor Nutrition:
Chronic wounds affect millions of Americans and others worldwide. The typical patient is old and not a young trauma patient where wounds tend to heal more easily. Chronic patients are often over 60 years of age and often have coexisting diseases such as diabetes, endocrine disorders, hypertension, renal disease, and peripheral vascular disease, to name a few. It’s also important to understand that an acute wound is not the same as a chronic wound and this requires different management considerations.
Understanding the role of nutrition in the management of wounds and healing is paramount. Ignoring the nutritional status of the patient leads to chronicity and poor outcomes. So why is nutrition such a large concern?
Elderly patients and patients with chronic diseases are found malnourished for a variety of reasons including depression, physiological, social, and economic. Malnourishment can be a combination of factors including protein, caloric intake, or specific mineral-vitamin deficiencies. Even obese patients can be malnourished.
“In 2006, ∼5–10% of older individuals living independently were considered malnourished. These statistics are seen to increase to 30–60% of institutionalized and 35–65% of hospitalized elderly. “ (JA Molnar, 2014). 1
The 2020 pandemic is sure to have added to these numbers.
“The presence of a chronic wound can increase protein requirements by 250% and calorie requirements by 50% in order to maintain an appropriate Lean Body Mass (LBM). Losses of 30% LBM halt healing and predispose the patient to new wound formation”. 1
In treating wounds, the nutritional status of the patient is paramount as previously stated. Patients with known issues need to consider the addition of zinc and perhaps arginine, an essential amino acid, that may not be present in sufficient quantities due to stress, trauma, sepsis, and wounds. Patients should consult a registered nutritionist to aid in their diet plans and to make sure the caloric intake is sufficient as well as other supplements.
Plan healthy, balanced meals and snacks that include the right amount of foods from all the MyPlate food groups — protein foods, fruits, vegetables, dairy and grains.
Choose vegetables and fruits rich in vitamin C, such as broccoli or strawberries. For adequate zinc, choose fortified grains and protein foods, such as beef, chicken, seafood or beans. Some wounds may require a higher intake of certain vitamins and minerals to support healing. Speak with your healthcare provider before starting any new supplements.
Include adequate protein throughout the day. Include a source of protein at each meal or snack. A sample menu may include scrambled eggs for breakfast, black bean tacos for lunch, yogurt or cheese for a snack and chicken at dinner.
Stay well-hydrated with water or other unsweetened beverages.
For people with diabetes, control blood sugar levels to help prevent wounds from developing and to support healing and recovery.
A registered dietitian nutritionist can work with you to develop an individualized eating plan that meets your specific needs.2