Wound care clinicians work diligently to find the most relevant products while using the latest evidence-based treatments to provide the best patient care.

For optimum wound healing to occur there is another important factor – a nutritious diet.

Proper nutrition for wound healing includes a diet with the right number of calories, vitamins, minerals and nutrients necessary to maintain skin integrity and promote wound healing.

To learn more about nutrition for wound healing, we spoke with Julie Stefanski, MEd, RDN, CSSD, LDN, CDE, FAND, spokesperson for the Academy of Nutrition & Dietetics and content writer for food, nutrition and dietetics at Relias Healthcare, about five of the most common myths regarding nutrition and wounds.

Myth 1: Protein supplements will always heal a wound

Stefanski: While protein is vitally important in healing skin breakdown, the total energy needs of a person must first be met. If a patient is not eating well and not meeting his or her total calorie needs, protein supplements can’t do their job.

Instead of using protein to build healthy tissue, the body will use it as an energy source until total calorie needs are met. It is important to help patients eat well at all meals to stabilize their weight when trying to heal skin breakdown because proper nutrition for wound healing is vital.

All amino acids are important for the body. When we start with a base of adequate whole protein sources – such as meats, nuts, dairy products, beans, eggs and vegetables – we get a wide array of amino acids from which the body can benefit.

A registered dietitian nutritionist will assess the protein being received from the current food and beverage choices before deciding whether a protein supplement is needed in addition to the patient’s current diet.

Myth 2: Patients with obesity cannot become malnourished or develop skin breakdown

Stefanski: There is a misconception that patients who are overweight aren’t affected by poor nutrition if they are not eating well. Significant weight loss in an overweight person with acute or chronic disease may be interpreted by some clinicians as beneficial, but that’s not the case.

Not only can a person with obesity develop skin breakdown because of poor nutrition for wound healing, but muscle loss associated with not eating well can lead to further decline in physical function. All patients, no matter their size, should be screened for poor intake and unplanned weight loss before malnutrition can progress.

For information about the importance of screening for malnutrition and the impact it can have on skin breakdown check out the course, Malnutrition Alert! How to Improve Patient Outcomes.

Myth 3: A multivitamin can meet all the needs of a patient with skin breakdown and wounds

Stefanski: Vitamin and mineral deficiencies can impair tissue synthesis, immune function, oxygen transportation and every phase of wound healing.

Patients with wounds need to meet all their vitamin and mineral needs, but sometimes a multivitamin just won’t cut it. Gummy vitamins in particular do not contain the minerals needed to repair damaged tissue.

If nutritional intake is poor or deficiency is suspected, a full-spectrum multivitamin is a good place to start. Additionally, vitamin C plays an important role in the synthesis of collagen.

The presence of a vitamin C deficiency can impact wound healing, so 500 mg of ascorbic acid twice a day may be beneficial.

A deficiency of vitamin A or zinc also can affect wound healing at all stages. Both of these nutrients should be given for limited duration if a deficiency is present. Zinc supplementation of 220 mg (ZnSO4/zinc sulfate) and vitamin A 10,000 IU, both daily for 10 to 14 days may be warranted.

Myth 4: Diet has minimal effect on skin integrity/skin health

Stefanski: Adequate nutrition for wound healing is an absolute necessity for injured tissue to recover. Every nutrient we eat plays a specific role in the maintenance of the human body, and many play an important role in supporting healthy tissue or the wound healing process.

In addition to adequate calories, sufficient protein is needed to support an effective immune response. Protein is needed to replace the nitrogen needed for day-to-day body repair and to replace any losses created by wounds.

If protein needs cannot be met by diet alone, a high-calorie, high-protein supplement may be needed.

Myth 5: If a person with diabetes has a wound, they should eat whatever they want to heal it

Stefanski: It’s important for a patient with diabetes to eat enough food to meet their calorie and protein needs. However, there also must be a good balance to control blood sugar levels.

Excessive glucose in the blood can contribute to poor wound healing, poor circulation and infections. Many long-term complications of poorly controlled diabetes also have an impact on wound healing.

Clinicians should work with patients to balance their food intake for optimal nutrition for wound healing, provide education on prescribed medications, and help find ways to keep patients’ blood glucose level as close to normal as possible.

Doing so can contribute to the success of interventions being used to heal skin breakdown.

Take our Skin and Wound Management Course for Registered Dietitians and Registered Dietitian Nutritionists to help you prepare for the Nutrition Wound Care Certified exam.

Carole Jakucs, MSN, RN, PHN, CDCES

Carole Jakucs, MSN, RN, PHN, CDCES, is a freelance writer and diabetes educator. Her background in nursing includes tenures in healthcare management and as a care provider. She has worked in med/surg/telemetry, a pediatric emergency department and college health.

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