By Windy Cole. DPM, CWSP, FAPWH
Macronutrients have been shown to play a vital role in wound healing. Proper nutrition is something that every wound care clinician should discuss with their patients. Caloric needs increase during wound healing and it is estimated that patients should consume 30-35kcal/kg daily. Recent reporting details daily recommended values of macronutrients in persons with open wounds as well as provides guidance on commonly available food sources.
Protein acts as an essential building block for tissue repair. Dietary protein provides amino acids that are essential in cellular metabolism. The body is in constant need of protein to support new cell growth. Therefore, sufficient protein intake is vital in patients with open wounds. Patients should be encouraged to include a high protein food source at every meal. It has been estimated that patients with wounds should consume roughly 1.2 – 1.5kg of protein per kg body weight daily. Food sources high in protein include eggs, meat, dairy, legumes, nuts, soy, seeds, and tofu.
Fats provide vital fuel necessary for wound healing. Dietary fats are broken down to produce ATP to provide energy to support cellular function therefore sparing protein for wound healing. Fat intake also assists in absorption of fat-soluble nutrients such as vitamin A and Omega-6 and Omega-3 fatty acids. Fatty acids are needed to synthesize prostaglandins. Without adequate quantities of two essential fatty Omega-6 fatty acids, linoleic and arachidonic, prostaglandin synthesis will be negatively affected and decrease the body’s ability to mount an immune response to bacteria and other antigens. Common food sources include olive oil, nuts, avocados, peanut butter, peanut oil, salmon, tuna, tofu, and eggs.
Carbohydrates provide an abundant energy source necessary for cellular proliferation, fibroblast migration, and leukocyte activity. Carbohydrates stimulate insulin production needed for anabolic activities during the proliferative phase of wound healing. But carbohydrate intake should be monitored closely in persons with diabetes since increased intake can result in hyperglycemia leading to a reduction in granulocyte function. Food sources high in carbohydrates include whole grains, pasta, brown rice, quinoa, green peas, potatoes, squash, legumes, oats, and beans.
Recognizing nutritional deficiencies in our at-risk patient population can be a simple, yet powerful way to support our patients along their journey to healing.
Source: Quain A, Khardori N. Nutrition in Wound Care Management: A Comprehensive Overview. Wounds. 2015;27(12):327-335.