This article, Nutrition and Wound Care, has been updated in June of 2016 to reflect NPUAP’s change in terminology.
Pressure injury can occur in health care settings or at home and affect more than 2.5 million Americans annually. The cost of treating just one Stage III or IV pressure injury may range anywhere from $5,000 to $50,000. Adequate nutrition status is paramount to wound prevention and helps to facilitate wound healing.
Patients are at increased risk for pressure injury if they have malnutrition, cachexia or are underweight. One in five nursing home residents with recent unintentional weight loss had pressure injury, according to a 2004 CDC survey.
Wound healing requires adequate calories, protein, fluid and micronutrient intake. Recommendations for most patients with pressure injury include:
Calories:
• 30-35 Kilocalories/kg/day for patients under stress with a pressure injury
Protein:
• 1-1.5 g/kg/day
• > 2g/kg/day may not improve wound healing and may contribute to dehydration in the elderly
Fluid:
• 30-35 mL/kg/day or 1 mL/Kcal consumed
• Fever, heavy wound exudate or use of air-fluidized beds or negative pressure wound therapy may increase fluid needs
Supplements:
• Multivitamin with mineral daily
• Consider additional vitamin C, zinc or other nutrients if a deficiency is suspected
Wound prevention and healing require a multidisciplinary approach. Screen all patients for nutrition status and pressure injury risk upon admission. Refer at-risk patients to a registered dietitian.
Reference: 1. The Role of Nutrition in Pressure Ulcer Prevention and Treatment: NPUAP White Paper, 2009 2. CDC Supports National Initiative to Improve Patient Safety http://www.cdc.gov/ 3. Office of Dietary Supplements http://ods.od.nih.gov/ 4. National Pressure Ulcer Advisory Panel (NPUAP) announces a change in terminology from pressure ulcer to pressure injury and updates the stages of pressure injury.
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