Nutrition to Heal Pressure Wounds
Pressure wounds, also known as pressure ulcers, commonly occur on bony joints or other weight-bearing areas of the body, such as the hips, heels, elbows or buttocks. This occurs when the area is exposed to friction or prolonged periods of pressure, causing skin breakdown. Bed sores that develop in individuals with limited mobility are a good example. Malnourishment greatly increases the risk for wound development and inhibits healing. According to the National Pressure Advisory Panel, adequate nutritional status is crucial for preserving skin integrity and for successful healing.
When the body does not receive adequate calories, it does not have the energy to heal open wounds properly or fight off infection. Having a pressure sore actually increases an individual's daily caloric requirements. The European Pressure Ulcer Advisory Panel (EPUAP) recommends that receiving a minimum of 30 calories per kilogram of body weight is necessary for receiving enough nutrition to promote healing. Its studies found that participants who received less than this amount had delayed healing, higher rates of infection and lower albumin levels, a lab measure of protein status.
Protein and Healing
Protein is the essential macronutrient responsible for tissue repair. Numerous studies, including those performed by the EPUAP, have found that higher albumin levels contribute to improved healing and decreased rates of infection. The panel's research also indicates that individuals who received at least 45 g of protein daily show dramatic improvements in skin integrity compared to those who received 20 g or less. Adequate calories and protein together promote skin cell replication, skin elasticity and the production of antibodies to fight infection.
Receiving adequate vitamin C, or ascorbic acid, is crucial in collagen synthesis. Collagen provides support for tissue to reform, especially in deep wounds. Without adequate vitamin C in the diet, collagen production is interrupted, leading to complications in wound healing. The University of California recommends 500 mg of vitamin C twice a day to decrease the size of the wound, however, further research is needed to evaluate its overall efficacy.
The mineral zinc also contributes to collagen synthesis and plays a role in immunity and the prevention of infection with an open sore. The University of California recommends that 220 mg of zinc three times daily may hasten wound healing because it helps prevent complications of infection. However, according to the journal "Annals of Long Term Care," an excess of zinc is shown not to benefit wound healing and can cause unpleasant gastrointestinal symptoms or anemia.
Preventing malnourishment is a critical factor in preserving skin integrity. In addition, it is important to consider hydration. Adequate hydration contributes to skin elasticity and prevents dry skin, which is more susceptible to injury. Individuals with limited mobility and who are more likely to develop these sores are often found to be dehydrated, exacerbating their condition. Hydration also promotes healthy blood volume and flow, which transports nourishment to affected areas.
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