Wound healing is energy-intensive. Cochrane reviews and ESPEN guidance agree that nutritional assessment is integral to chronic wound care.
Screening
Use MNA-SF in older adults or MUST in general adults at the start of care, then monthly.
Protein
Healthy adults need 0.8 g/kg/day; patients with chronic wounds need 1.25–1.5 g/kg/day, and stage 3–4 pressure ulcers up to 2 g/kg/day.
Micronutrients
- Vitamin C — collagen synthesis
- Vitamin A — epithelial proliferation
- Zinc — cofactor of repair enzymes
- Iron — tissue oxygen delivery
- Arginine and glutamine — collagen and immune function
References
- Cereda E, et al. Nutritional formula for pressure ulcer healing — RCT. Ann Intern Med. 2015;162(3):167–174. https://doi.org/10.7326/M14-0696
- Posthauer ME, et al. Nutrition for pressure ulcer management — NPUAP/EPUAP/PPPIA white paper. Adv Skin Wound Care. 2015;28(4):175–188. https://doi.org/10.1097/01.ASW.0000461911.31139.62