Role of nutrition in wound healing

Posthauer, M. E. (2012). The role of nutrition in wound care. Advances in skin & wound care, 25(2), 62-63.

Posthauler, conducted a study on how nutrition contributed to wound care. In addition, the author investigated how malnutrition increases the risk of pressure ulcer (PrUs) healing. The scope of the research involves elderly patients suffering from pressure ulcers. The author used prospective cohort, Interventional and randomized studies. The research concluded that wound healing requires protein because it promote positive nitrogen balance. Moreover, all healing stages needed sufficient protein. The study also investigated the protein requirement for older adults, where the researcher noted that, they require minimum levels of protein at 1.0 g/kg of body weight in patients with Pressure ulcers.

Besides, the researcher noted that patients with PrUs should use bio-available types of protein from supplements and food sources. The research indicated that protein increased activity of antioxidants, combats inflammation and fatigue, fastens healing and reduced related infections. Beside, Posthauler argued that adequate protein enhances stamina and improves immunity and natural antibiotic properties. The author also argues that sufficient nutrition could not be accomplished orally, but parenteral nutrition is necessary depending on the individual goals. The research by Posthauler could have possible biases because it only concentrated effects of protein on pressure ulcers (PrU) healing, hence did not study other forms of wounds and nutrients such as fats or carbohydrates. Posthauler  concludes that the malnutrition problems are very common among different patient, hence proper nutritional guideline helps the nurse to make appropriate decisions on a particular condition.  The study findings indicated that protein plays a crucial role in the synthesis and repair of enzymes involved in wound healing. It is also responsible for cell multiplication and antibodies component that helps in immune system function. However, inadequate protein can cause wound remodeling, collagen synthesis, proteoglycan synthesis, and proliferation of fibroblast. When an adult is injured, he or she requires a minimum level of one to 1.5/kg/day.

Stechmiller, J. K. (2010). Understanding the role of nutrition and wound healing. Nutrition in clinical practice, 25(1), 61-68.

The article focuses on the role of nutrition in wound healing process. Specifically, it covers the role played by nutrients in enhancing the healing process. The information comes from a reputable sources. The author argues that for maximum wound healing the body needs sufficient nutrition. Chronic wounds cause adverse effects in the body because they result in mortality and morbidity in many people hence they are a serious concern. In a healthy individual, acute wound healing takes the physiological sequence of hemostasis, inflammation, epithelialization, fibroplasia and maturation. In case the process of healing is changed, it may develop a chronic wound. A patient requires adequate nutrition to enhance rebuilding and healing of tissues. Nutrients are needed for collagen formation. Collagen is a fibrous protein that connects the ligaments, tendons, cartilage and skin. Sufficient hydration and nutrition is important to enhance healing time and control infection by enhancing the immune system.

The findings of the study indicate that a wound changes the process of metabolism of nutrients in the body. During the process of wound healing, the body releases stress hormones and utilizes more resources such as antioxidants, proteins, fats and carbohydrates in the creation of new tissue. The process is referred to as a catabolic healing phase. The body metabolism increases during the catabolic phase. However, in case the catabolic phases take a long period, the body initiates protein energy malnutrition (PEM). Consequently, a negative cycle set in that reduces the rate of wound healing and negatively affect the health of the patient. The author concludes that the body utilizes more proteins to the wound while other critical body organs and systems lack sufficient protein. Ultimately, it causes delayed healing of wound and reduced muscle mass. However, the article fails to study a specific group of people, hence there is possibility of bias.

Wild, T., Rahbarnia, A., Kellner, M., Sobotka, L., & Eberlein, T. (2010). Basics in nutrition and wound healing. Nutrition, 26(9), 862-866.

A study by Wild, Rahbarnia, Kellner, Sobotka & Eberlein, (2010) offers robust evidence that proper nutrition can play a crucial part in the capacity of the body to heal wounds. The experiment was carried out on young rats after they were exposed to a burn injury. The rats were kept into two different groups. One group of rat was treated with highly nutritious foods such as vitamins, choline and nutrients such as zinc. The study established that high-dose of Vitamin C increased the blood flow of the rats and promoted faster repair of tissues. Vitamin C also facilitated collagen synthesis in the rate.

The research concluded that consistent use of high-dose supplements of vitamin C helps to hasten the rate of wound healing. Moreover, the study determined the effects of choline on the wound healing process. Rats that received a sufficient amount of choline had faster healing. Choline helps in acetylcholine formation in the brain, which plays a crucial role as a chemical messenger. Rats that had brain injuries had showed improvement in test performance and memory following choline diets. Sufficient amounts of zinc are also crucial during the healing of wound.

The study established that lack of adequate zinc increased the blood sugar levels in the rats’ body and increased insulin resistance. Insufficient zinc also raised the oxidative damage and delayed wound healing process. The findings concluded that choline is very useful in neuro-repair and acts as a neuro-protector during the wound healing process. In addition, that research noted that following an injury, the micronutrients and macronutrients metabolism changes. In addition, wound healing involves metabolic, growth factors, tissues and blood cells demands for nutrients.

Chan, M. M., & Chan, G. M. (2009). Nutritional therapy for burns in children and adults. Nutrition, 25(3), 261-269.

Chan, & Chan investigated on the importance of nutrition in children with wounds. The research notes that children have a faster growth rate, hence their nutritional needs are higher. They need more protein, calories and water per body unit relative to adults. Children have also higher risk of gastrointestinal infections.  The feeding of children through parenteral, enteral or oral methods are usually incapable of meeting the needs of wound healing in children. Mineral, protein and energy needs are increased to allow increased energy expenditure. Synthesis of collagen is needed for to support the immune activity ad healing. The presence of a wound cause huge loss of nutrients hence proper nutrition replaces these nutrients. Lack of adequate diet affect the normal physiological process that permits wound healing. In addition, malnourished patients have a higher risk of developing infections, ulcers and slow healing of wound that lead to chronic non-healing wounds.

Sufficient intake of calories is crucial to replace protein calories for wound healing. Children who are aged between 0 and 6 years have proteins needs of 3 g to 4.5 g in every kilogram of the body weight. Besides, children with more than 6 years require 2.5 g to 3 g protein per kilogram of body weight. The amount of fluid should be increased due to higher insensible and urinary water losses. The possible biases in the study are involving a thorough nutritional assessment to identify specific deficiencies and permit individual management plans to be initiated. The author concludes that the capacity of a wound to heal is affected by the patient’s nutrition status. The possible bias of the study is that it failed to investigate the effects of other essential elements in the body such as carbohydrates in the healing process.

References

Chan, M. M., & Chan, G. M. (2009). Nutritional therapy for burns in children and adults. Nutrition, 25(3), 261-269.

Posthauer, M. E. (2012). The role of nutrition in wound care. Advances in skin & wound care, 25(2), 62-63.

Stechmiller, J. K. (2010). Understanding the role of nutrition and wound healing. Nutrition in clinical practice, 25(1), 61-68.

Wild, T., Rahbarnia, A., Kellner, M., Sobotka, L., & Eberlein, T. (2010). Basics in nutrition and wound healing. Nutrition, 26(9), 862-866.