Malnutrition and Wound Care: A Dreadful Duo

Check out these top tips to recognize, treat and prevent malnutrition – and get those patient wounds healing.

Malnutrition and Wound Care: A Dreadful Duo

(Adapted from Tips to Recognize, Treat and Prevent Malnutrition by Amy Carrera, MD, RD, CNSC)

Malnutrition in the hospital setting can be more common than you think. In fact, up to half of hospitalized patients are either malnourished or at-risk of malnutrition. And when it comes to wound care, malnutrition can cause a number of complications, including delayed wound healing, infection, and other problems that may lead to hospital readmissions.

Let’s take a closer look at what malnutrition actually is, what happens when patients are malnourished, and some tips to recognize, prevent and treat it.

What Is Malnutrition?

Although there is currently no clear definition of malnutrition in terms of diagnosis, a set of characteristics has been proposed by the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and the Academy of Nutrition and Dietetics (AND). They include:

Malnutrition Characteristics

Consequences of Malnutrition

Malnourished patients can experience a number of consequences, which include:

  • Twice to three times more prone to experience post-operative complications, such as infection and delayed wound healing
  • Twice as likely to require specialized care at home
  • More frequently admitted to the hospital and have longer hospital stays

Symptoms of Malnutrition

So what happens with a patient becomes malnourished? Here are some of the most common symptoms:

  • Unplanned weight loss
  • Loss of appetite
  • Not eating, or only eating small amounts
  • Weakness and/or fatigue

Preventing and Treating Malnutrition

There are a number of measures that health care professionals can take to maintain or improve patient nutritional status, including:

  1. Screen for malnutrition upon admission to the hospital or long-term care facility using one of the many tools such as the Mini Nutritional Assessment or “MNA”
  2. Refer to a Registered Dietitian Nutritionist for treatment and preventive care.
  3. Consider oral nutrition supplements (ONS) to supplement poor oral intake.  ONS have been shown to reduce hospital length of stay, 30-day hospital readmission and total health care costs
  4. Establish a post-discharge nutrition plan:
    –  Arrange follow-up medical care
    – If the patient has a caregiver, have clear communication about the patient’s nutrition needs
    – Prescribe an oral nutrition supplement or recommendation if needed
    – Collaborate with a Registered Dietitian Nutritionist

Tips for Caregivers

Elderly caregivers are particularly at-risk for malnutrition. In a study of 76 family caregivers (mean age 70 years) who spent an average of 100 hours per week on caregiving activities:

  • 13% reported not eating
  • 21% were at risk for malnutrition

Due to decreased overall food intake, it is even more important for older adult caregivers to eat nutrient-dense foods. Some good examples include:

  • Low-fat yogurt and milk
  • Whole grain bread/crackers/tortillas
  • Beans, eggs, cheese
  • Nuts, seeds, nut butters
  • Brightly-colored fruits and vegetables
  • Water, milk and other fluids

Do you know malnutrition when you see it?

Were you already familiar with the signs and symptoms of malnutrition? And how much has malnutrition affected the wound care patients within your facility? We’d love to hear about your experiences, along with any additional tips you can share. Please leave your comments below.

Shield HealthCare’s mission is to serve the medical supply needs of patients at home with compassion and exceptional customer service. At the heart of Shield Healthcare is a corporate culture of caring and committed employees. With more than 58 years of medical supply experience serving the caregiving community, Shield HealthCare is a recognized leader in Incontinence, Urological, Ostomy, Enteral Nutrition, Wound Care, and Breastfeeding supplies. With ten sales locations serving California, Colorado, Illinois, Texas and Washington, Shield HealthCare is actively engaged in local communities to educate, inspire and support caregivers and families with chronic medical needs.

Wound Care Education Institute® provides online and onsite courses in the fields of Skin, Wound, Diabetic and Ostomy Management. Health care professionals who meet the eligibility requirements may sit for the prestigious WCC®, DWC® and OMS national board certification examinations through the National Alliance of Wound Care and Ostomy® (NAWCO®). For more information see

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