About pressure injuries
Pressure injuries and wounds can result for a number of reasons e.g. long periods spend in bed or as ulcers from poor management of diabetes. When people develop pressure injuries or wounds, they rarely consider the quality of their nutritional intake. Whilst appropriate wound hygiene and dressing is extremely important, nutrition can also play a big helping hand in recovery! After all, your body needs a good store of proteins, vitamins, minerals and energy to repair and build tissues.
Dietitians see most pressure injury cases in the hospital but it’s very important for outpatients to be aware of the important role nutrition plays. Many people in the community managing a wound can delay their healing time without realizing if they aren’t eating adequately.
Assessment of risk and management
When in a hospital or outpatient setting, a dietitian will assess the patients nutritional risk i.e if they are at risk of malnutrition and whether this will delay wound healing.
Low risk
If the patient is well nourished then additional information on a well balanced, healthy diet will be provided.
Moderate risk
If the individual is at moderate risk of delayed healing due to nutritional deficits/ inadequate intake then they should definitely receive an assessment from a dietitian, if they haven’t done so already. This can be the case for most people with poorly managed diabetes or the elderly who often neglect their diet.
For people at a moderate risk of delayed healing, it is beneficial to have an increased protein and energy intake. The body will likely require higher than normal amounts of protein and energy to assist with the healing process. Adequate fluid intake is also important. A dietitian will be able to determine the appropriate protein and energy targets for the person. It is important to ensure a balanced diet as well because all of the vitamins and minerals play different roles in the healing process and inadequate amounts of them cal also delay healing.
High risk
Those who are at a high risk of delayed healing secondary to nutrition will likely require an even higher protein and energy intake. These people will probably benefit from a nutritional supplement to assist in meeting their protein and energy requirements – particularly when appetite is poor.
It can be difficult to consume enough protein and energy that the body demands for the ulcer to heal promptly so a dietitian can arrange or recommend supplements to help. In saying that, people should still aim to eat as well and nutritious as they can. Tips will be provided on easy ways to fortify foods with additional energy and protein.
Indicators of high risk for delayed healing can include:
- Recent unintentional weight loss.
- Moderate to high risk of malnutrition – determined by the appropriate nutrition assessment tool.
- Decreased intake for 5 or more days.
- Low BMI.
Stage 3 and 4 pressure injuries are automatically classed as high risk of delayed healing.
Monitoring
Once a wound starts to heal, patients can progress backwards through the above stages and slowly decrease their protein/ energy intakes back to a normal range. This should always be done under the guidance of a dietitian.
Who should follow this information?
As mentioned earlier, it is wise to consult a dietitian if you have a pressure ulcer. Many people can think they are doing the right things nutritionally but they are often missing out on vital nutrients. This information is very important for anyone who develops wound. If you do not seek the help of dietitian then ensure you are doing the best you can to eat regular meals and nourishing snacks that are full of protein, energy and micronutrients.
Contact us for results focused nutritional advice
This article was written by our dietitian Belinda Elwin who is a Dietitians Association of Australia member and Accredited Practising Dietitian and Nutritionist. If you have questions about healthy eating, make an appointment. We‘ll provide you with a simple and effective routine targeted to your concerns. Contact us today.
