Download Nutrition Management of Pressure Ulcers

Nutrition Management of Pressure Ulcers Q&A
Is nutrition related to the development and healing of pressure ulcers?
Yes, there are many factors that increase the risk for pressure ulcer development. Eating well is
not the only way to prevent or treat a pressure ulcer, but it is an important factor. Malnutrition
or under-nutrition, unintended weight loss, and inadequate food/fluid intake are risk factors for
pressure ulcers.
Other risk factors include:
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Age (elderly people are more at risk for pressure ulcers)
Immobility (bedridden or rarely out of bed)
Inability to control bowel and/or bladder
Poor circulation
Individuals with dementia or confusion may be at higher risk because they might not notice a
wound before it gets very serious.
Why does a healthy diet prevent pressure ulcers?
The skin is the largest organ in the body. It is about 10% of your body weight. Your skin protects
your body, and is involved in regulating body temperature and making vitamin D from sunlight.
It has three layers: 1) the epidermis, or the thin outer layer; 2) the dermis, which provides
support and supplies oxygen and blood to the skin; and 3) the subcutaneous tissue, which
supplies a cushion between the skin layers, muscles, and bones. Each layer of skin is made up of
different types of cells and has different functions.
Proper nutrition will help keep your skin healthy and allow it to complete the job of rebuilding
in the event of a cut or other type of damage. People who cannot or will not eat well are
associated with a higher risk of developing skin breakdown. Eating a healthy diet that includes
good sources of protein (meat, fish, poultry, eggs, dairy foods, dried beans and peas, nuts, and
soy) will help your skin heal.
Vitamins and minerals (found in many foods, but especially in fruits, vegetables, and whole
grains) and fluids also are important to skin health. Eating a variety of foods and following the
MyPlate guidelines (www.ChooseMyPlate.gov) can help at-risk individuals from developing a
pressure ulcer.
Will eating a special diet heal a pressure ulcer?
Maybe! In general, registered dietitians (RDs) and registered dietitian nutritionists (RDNs)
recommend an overall healthy diet when a person has a pressure ulcer. You should make sure
you eat plenty of protein, vitamin C, and zinc because these nutrients play a role in wound
healing. Keeping well hydrated is also an important part of a wound-healing plan. Try to include
a least 3-4 glasses of water in your daily diet in addition to your favorite beverages.
Do I need to take vitamin supplements?
Maybe! A multivitamin might provide good insurance, especially if you are a poor eater.
However, many people can meet their nutrient needs through diet, even if they have a pressure
ulcer.
Vitamin C and zinc are both thought to play a role in the healing of wounds. Supplements may
help those who consume a poor diet that may be deficient in these nutrients, but it is best to
try to use foods to meet your vitamin C and zinc needs. Try to eat a good source of vitamin C
and zinc each day.
Good sources of vitamin C include:
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Citrus fruits
Green vegetables, such as broccoli, kohlrabi, spinach, and collard greens
Others fruits, including strawberries and cantaloupe
Red and green bell peppers
Tomatoes and tomato juices
Tropical fruits, such as guava, papaya, and mango
Zinc is found in foods from animal sources, such as:
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Eggs
Liver
Meat
Milk
Seafood
Tofu
Wheat germ
Whole-grain foods
What are good sources of protein?
Your body needs protein to help your wounds heal. Most people with wounds can get enough
protein by eating two to three servings of dairy foods and two to three servings of other good
sources of protein each day. Some people may require nutritional supplements to help meet
their protein and calorie needs.
If you are eating a healthy diet you can easily get enough protein by enjoying:
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Dairy foods: milk, cheese and yogurt
Eggs
Dry beans and peas
Meat, fish, poultry
Nut butters
Nuts
Seeds
Soy foods
Can I get enough protein if I do not eat meat?
Probably. You can choose from many good sources of protein if you do not eat meat or dairy
foods. Protein is found in almost every food except for fruit, but in small amounts in some
foods. Rich sources of protein from vegetable sources include:
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Legumes, such as black beans and black-eyed peas
Nut butters
Nuts
Seeds
Soy foods, such as soy milk, tofu, and veggie burgers
Not all plant-based proteins contain all the amino acids needed to make a complete protein. To
make sure that you are getting a variety of amino acids, choose many different vegetable
sources of protein each day.
Older individuals require slightly more protein than younger people, so it is sometimes more
challenging to obtain enough protein from vegetarian sources.
What are some tips to add protein and calories to my menu plan?
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Add dry milk to cream soups, mashed potatoes, casseroles, and pudding.
Add one-third cup of nonfat dry powdered milk to each cup of regular milk.
Add cheese to vegetables, salads, sandwiches, potatoes, rice, noodles, and casseroles.
Add yogurt to fruit and cereal. Note: Greek yogurt has more protein than regular yogurt.
Add nuts, seeds, or wheat germ to casseroles, breads, muffins, pancakes, and cookies.
Sprinkle nuts, seeds, or wheat germ on fruit, cereal, ice cream, and yogurt, or use in
place of bread crumbs.
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Add nut butter to sandwiches, toast, crackers, or muffins; use as a dip for vegetables
and fruit, or add to milk and blend.
Add dry beans to soups or casseroles.
Do I need to take a protein supplement?
Some people with a poor appetite or with very high protein needs may benefit from high
calorie, high-protein supplements. A variety of high-protein shakes, bars, and powders are
available. An RD or RDN can help you decide if you need one and which one is best for you.
Commercial supplements provide a range of vitamins and minerals such as vitamin C, zinc, etc.
Are other foods available that can help my wound heal?
For years, scientists have studied wound healing and nutrition to see if they can find a “magic
bullet.” An overall healthy diet that provides enough protein, calories, vitamins, minerals, and
fluids for your needs is the best nutritional medicine for your wounds. Specialized medical
nutrition therapies that include vitamins, minerals, and/or amino acids are available as adjunct
therapy for non-healing wounds and may be helpful in some cases.
References and recommended readings
Baranoski S, Ayello EA, Tomic-Canic M, Levine JL. Skin: An essential organ. In: Baranoski S,
Ayello EA, eds. Wound Care Essentials. 3rd ed. Philadelphia, PA: Lippincott Williams and
Wilkins; 2012:83-100.
Hauser E. 2014 prevention and treatment of pressure ulcers: clinical practice guideline.
http://www.internationalguideline.com/. Accessed November 3, 2015.
Posthauer ME, Banks M, Dorner B, Schols JMGA. The role of nutrition for pressure ulcer
management: National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel
and Pan Pacific Pressure Injury Alliance white paper. Adv Skin Wound Care. 2015;28(4):175-188.
doi:10.1097/01.ASW.0000461911.31139.62.
Contributed and updated by Nutrition411 Staff
Review date: 10/18/15