Nutrition	and	Wound	Healing
                                                                                                          ©Food	Solutions	2017
                               Overview
                               § Background	on	Wounds
                               § Risk	Factors	for	Wounds
                               § The	role	of	Nutrition	for	Wound	
                                  Healing
                               § Steps	for	Nutrition	Support	in	
                                  Wound	Healing
                               § Quick	Quiz
                               Aims	and	Objectives
                               Aim:	
                               •  To	increase	general	knowledge	of	nutrition	and	wound	healing	
                                  to	improve	outcomes	for	residents	with	wounds
                               Objectives:
                               •  To	identify	those	with	wounds	who	are	also	at	nutritional	risk
                               •  To	identify	the	role	nutrition	plays	in	wound	healing
                               •  To	identify	ways	to	increase	nutrition	support	for	those	with	
                                  wounds	or	poor	wound	healing
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                            Background	on	Wounds
                            54.8%	of	all	wound	types	in	elderly	are	skin	tears	
                            >4%	of	>65yo	have	chronic	leg	ulcers	(vs	1-2%)
                            Pressure	injury	prevalence	amongst	Australians	in	aged	
                            care	~26%	
                            Nearly	25%	in	RACFs	will	have	a	wound	of	some	type	at	
                            one	time
                            Negative	Consequences	of	chronic	wounds
                            Reduced	mobility
                               Decreased	QOL
                                     Reduced	independence
                                         Pain	and	discomfort
                                             Depression
                                                  Increased	morbidity	and	mortality
                                                      Increased	health	costs
                            Risk	Factors	for	Wounds
                            •  Increased	age
                            •  Comorbidities	(T2DM,	RF,	PVD)
                            •  Polypharmacy
                            •  Poor	immune	system
                            •  Poor	skin	integrity
                            •  Incontinence
                            •  Malnutrition	
                            •  Dehydration
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            Current	guidelines	for	nutrition	&	wound	healing
            Role	of	Nutrition	in	wound	healing
                Nutrient	deficiencies	impede	wound	healing	
                  • extend	inflammatory	phase
                  • alter	the	synthesis	of	collagen
                  • decrease	proliferation	of	fibroblasts	
            Role	of	Nutrition	in	wound	healing
           Nutritional	requirements	higher	for	wound	healing
            • Need	for	increased	cell	proliferation,	enzyme	
              activity	and	protein	synthesis	
            • Requires	energy	from	calories,	plus	increased	
              substrates	sourced	from	protein	and	
              micronutrients
            • Glutamine	(an	amino	acid)	is	the	preferred	energy	
              source	of	fibroblasts	&	increases	collagen	
              deposition
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                            Nutrients	required	for	Wound	Healing
                            •  Macronutrients	
                                – Energy	(kJ/calories)	from	carbohydrates,	fats	&	protein
                                – Extra	Protein	including	Arginine	and	Glutamine	
                            •  Micronutrients
                                – Zinc,	Copper,	Vitamin	A	&	C	
                            More	Energy
                            •  Both	malnutrition	and	pressure	injuries	can	produce	a	
                               hypermetabolic	state	à increase	energy	requirements
                            •  Extra	energy	is	required	to	produce	collagen	+	maintain	
                               normal	body	functions
                                •   If	caloric	needs	are	not	met,	dietary	protein	becomes	an	energy	
                                    source	instead	of	being	used	for	wound	healing
                            •  Increasing	caloric	intake	promotes	anabolism,	nitrogen	
                               and	collagen	synthesis
                            ​
                            Sources:	Breads,	Oils/Fats,	Cereals,	Tofu,	Legumes,	Beans,	
                            Nuts,	Seeds,	Meat	and	Dairy
                            Energy
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