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A wound is defined as a break in the continuity of the skin and can be caused by injury, surgery, pressure, or friction. The skin acts as a protective barrier so any damage to it increases susceptibility to infection.
An acute wound is a wound which usually heals in an ordered, timely fashion. Acute wounds typically fall into one of two categories: traumatic wounds (a wound caused by a fall or accident) and surgical wounds (caused by a surgical cut during an operation).
A chronic wound is a wound that develops over a longer period of time. Chronic wounds may not heal in an orderly set of stages and in a predictable amount of time. Examples of chronic wounds include pressure ulcers (also called bed sores, pressure sores or pressure wounds), leg ulcers, diabetic wounds (including diabetic foot and diabetic ulcers).
Impaired or delayed wound healing refers to a wound that does not heal over time. Wounds which are slow to heal, or which do not heal, cause patients severe emotional and physical stress. Good wound care aims to support the wound healing process through the use of dressings, pressure relief, and correct nutrition.
Wound care management
Nutrition for wound healing
Wound care management
If you have a wound you may be receiving treatment from a variety of healthcare professionals, in addition to your doctor or surgeon, you may also receive treatment from a:
- Tissue viability nurse, public health nurse or wound care nurse – this is a nurse who manages the day to day treatment of your wound. The treatment plan may involve:
Wound assessment – the nurse will carefully examine and evaluate your wound to determine how best to treat it.
Wound treatment – this may involve the use of dressings, wound debridement (removal of infected or dead tissue), medication and/or nutritional supplementation.
Wound treatment also involves the management of the underlying cause. For example, pressure relief is important in the treatment of pressure, management of blood sugar levels is important for the treatment of diabetic wounds.
A dietitian will assess your diet and make recommendations on any required changes you need to make to your food intake to be certain that you are providing your body with the right type of food to support wound healing. The dietitian may recommend that you increase or decrease your intake of certain foods or nutrients, or, if you are unable to meet your nutrition needs from normal food, that you supplement your dietary intake with an oral nutritional supplement (also called sip feeds or nutrition drinks).
Nutrition for wound healing
The importance of good nutrition in the healing of wounds is widely accepted. Where good nutrition facilitates healing, malnutrition (also known as poor nutrition or undernutrition) inhibits it and complicates the process.
The following nutrients have a key role to play in the wound healing process:
Protein is the building block of all the major organs in the body, including the skin and muscle. Inadequate intake of protein will inhibit the wound healing process. Protein is also essential to make sure that the infection fighting cells of the body function properly to prevention infection at the wound site.
Arginine is an amino acid (basic block of protein). Arginine supplementation has been shown to increase the amount of protein deposited at the wound site and in this way it may help to promote the healing of certain types of wounds.
When you have a wound, your body has an increased demand for energy to support the healing process. If your intake of energy is less than your requirements the wound healing process is inhibited. The main sources of energy in the diet are carbohydrate and fat.
If you are dehydrated this can impair the wound healing process. You should aim to drink a minimum of 1500ml or 6-8 cups of fluid a day – this can include water, milk, juice, squash, soup, tea or coffee.
Deficiency of vitamin C impairs wound healing and has also been associated with an increased risk of wound infection. Research shows that vitamin C supplementation helps to promote healing. Vitamin C is found mostly in fruit and vegetables, especially oranges, grapefruit, kiwis, tomatoes and green leafy vegetables.
Low vitamin A levels can result in delayed wound healing and susceptibility to infection. Vitamin A is found in milk, cheese, eggs, fish, dark green vegetables, oranges, red fruits and vegetables.
Zinc is a trace element, present in small amounts in the body, which has a well established role in wound healing. Zinc deficiency has been associated with delayed wound healing, reduced skin cell production and reduced wound strength. Dietary sources of zinc include red meat, fish and shellfish, milk products, poultry and eggs.
Nutritional supplementation for wound healing
If you are unable to consume sufficient amounts of these nutrients through normal foods, you may benefit from supplementing your diet with an oral nutritional supplement (ONS). An ONS is a special drink which contains all the nutrients your body needs. Cubitan® is a wound specific ONS which contains higher levels of the wound specific nutrients listed above. In clinical trials patients who consumed Cubitan® in addition to receiving standard wound treatment, had faster healing rates, and a reduced need for dressing changes, than patients receiving standard care.
The content provided by Nutricia is for information purposes only and is in no way intended to be a substitute for medical consultation with your doctor, dietitian or healthcare professional. The information, opinions, and recommendations presented in these pages are not intended to replace the care of your own doctor, dietitian or healthcare professional. Before you make any changes in the management of your diet / treatment or any other persons diet /treatment you should always consult your doctor, dietitian or healthcare professional. Although we carefully review our content, Nutricia cannot guarantee or take responsibility for the medical accuracy of documents we publish, nor can Nutricia assume any liability for the content of any web site linked to our site. © 2010 Nutricia. All rights reserved.