Pressure ulcers are a significant and expensive healthcare problem for patients and healthcare providers. Understanding the role that nutrition plays within the prevention and management of pressure sores is crucial in helping to aleviate the condition or potentialy even stop them from happening.
Pressure ulcers are known as decubitus ulcers, pressure sores, and bedsores. The National Pressure Ulcer Advisory Panel defines them as ‘localized areas of tissue necrosis (cell death) that develops when soft tissue is compressed between a bony prominence and an external surface for a protracted amount of time’. Therefore, pressure ulcers are most likely to occur on the sacrum, hipbone and the heels.
There are four completely different stages of pressure sores and each stage can vary in severity. Skin that is intact and reddened and non-blanchable is considered a stage one ulcer. These ulcers can look, red, blue or purple in individuals with darker skin tones. A stage two ulcer is partial thickness skin loss involving the epidermis, dermis, or both. Damage to or necrosis of subcutaneous tissue, with full thickness skin loss is a stage three ulcer. A stage 4 ulcer is full thickness skin loss with intensive destruction, tissue necrosis, or harm to muscle or bone.
A correct assessment of the risk of developing a pressure ulcer, or the stage of an existing ulcer, can help confirm the correct dietary intervention. Other factors together with other medical conditions, age and the weight of the patient ought to additionally be taken into account. The next recommendations are a general guide to diet in pressure sores. A dietician ought to be consulted to amend them to a particular case.
To spare protein calories are needed. A decreased blood supply will furthermore boost the calorie necessity and can cause a pressure sore to become infected. The recommended calorie consumption for treating pressure ulcers is typically thirty to thirty five calories per kilogram. Amounts will vary though, and can want to be adjusted for obese patients.
There isn't any known advantage of excessive calories on wound healing. But, the spectrum of macronutrients will create a difference. Acceptable macronutrients can typically speed up healing and prevent infection.
An inadequate protein intake delays wound healing and prolongs the inflammatory (damaging) part of pressure ulcers. For that reason 1.2-1.5 grams per kilogram of protein is recommended in the treatment of pressure ulcers. Expressed as a percentage, a minimum of 24% of the calorie intake should come from calories. Not only is a high-protein diet important and beneficial but the sorts of protein supplements are furthermore significant.
For any person that has pressure ulcers, whey proteins are a great substitute. Whey proteins make a good nutritional candidate for healing. Essential amino acids that need to be provided from the diet comprise 60% of whey protein. Because whey protein has a first-class amino acid profile, it is easily digestable, and has a high utility quotient it is one of the top rated proteins, in current protein quality scoring methods . Exciting new research indicates certain whey protein components additionally help promote the growth of new body tissues. Whey proteins are also known for their regeneration and repair affects in our bodies.
Casein constitutes eighty percent of the total nitrogen in milk. Glutamic acid is the predominant amino acid in casein. Proline, Aspartic Acid, Leucine, Lysine and Valine are also present. Casein is a smart source of essential amino acids. Casein is also a smart source of non-essential amino acids like arginine and glutamine that repair the damaged muscle fibers and maintain a healthy immune system. Arginine supplementation seems to benefit wound healing even if the patient is not deficient. Oral supplementation of 17 to 24.8 grams of free arginine each day has been shown to have a bearing on wound healing. The safe maximum consumption of glutamine is 0.57 grams per kilogram.
A high fluid intake is also needed to take care of good skin turgor and blood flow to wounded tissues. A major risk factor for skin breakdown and pressure ulcer is dehydration, which can prevented with increased fluid intake. The fluid intake ought to match the person’s weight (30 to thirty five milliliters per kilogram) and also the calorie intake, as well (one ml/cal). Correct calorie consumption from a fluid-based protein diet can achieve the most effective result. More fluids might be needed if there is a fever, or if there is fluid loss from an open wound.
The healing process of pressure ulcers requires micronutrients. Vitamin C aids in collagen synthesis and expedites wound healing. Vitamin A additionally enhances collagen formation, and a deficiency leads to delayed wound healing and increased vulnerability to infection. Zinc is required for both collagen formation and protein synthesis. Low serum zinc levels have been associated with impaired healing. Recommendations for treating pressure ulcers are typically fifteen to twenty five mg of elemental zinc daily, which is present in sixty six to one hundred ten mg zinc sulphate. However, long-term excessive use of zinc supplementation can induce a copper deficiency, thus zinc should be taken for ten days and then the wound ought to be reassessed.
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About Protica Research
Founded in 2001, Protica Research (Protica, Inc.) is a nutritional research firm specializing in the development of capsulized foods (dense nutrition in compact liquid and food forms). Protica manufactures Profect (www.profect.com), IsoMetric, Pediagro, Fruitasia and more than 100 other brands in its GMP-certified, 250,000 square foot facility. One area of specialty is the manufacturing of Medicare-approved, whey protein liquid for renal care patients.
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