January 10, 2018 - Skilled Wound Care
Welcome to another installment of our wound care insights series!
As we all know, the new year is a time for resolutions, and one of the most common new year’s resolutions is to be more healthy - and whether that means going to the gym, walking around the neighborhood, or just eating better in general, we’re all thinking about how to take better care of ourselves.
So let’s take that a step further. As we’re thinking about taking better care of our own bodies, let’s also use that motivation towards better nutritional health when caring for our patients.
We are the caregivers for one of the most vulnerable and underserved populations, and we need to look out for their health as much as we do our own. Proper nutrition is one of the best and most basic ways to help a wound heal, as well as improve general health and, by extension, quality of life.
Here are some of the top nutrition tips for the elderly and nursing home patients:
Increase protein intake
Proteins are vital for maintaining body mass in a patient with a wound. When a wound is present, protein demands in the body increase, and if there is insufficient protein to meet that need, it negatively impacts the speed and quality of wound healing.
Proteins are commonly found in meat, poultry, fish, legumes, and dairy, but patients may also be given protein shakes or a protein supplement in a feeding tube.
Amino Acids: Arginine and Glutamine
Arginine is an essential amino acid, the need for which becomes increased during times of stress, as seen in patients with wounds. Arginine is usually synthesized in the kidney and liver from gut–derived citrulline, but when this mechanism is not enough to produce arginine for wound healing, supplementation is required.
Arginine is a necessary precursor for the production of other amino acids, which are essential for aiding in wound healing. Supplementation of arginine is between 4.5–9 mg/day, and multiple studies demonstrated improved wound healing for an assortment of wound etiologies with arginine.
Glutamine is another essential amino acid that is found in great abundance within the body. It is responsible for a variety of mechanisms that include gut function, decreased septic complications, and insulin sensitivity. Patients with trauma or sepsis have an absolute need for glutamine. The safe maximum dose for glutamine supplementation has been established as 0.57 grams per kilogram of body weight per day.
Both of these, however, rely on the presence of protein in order to be of maximum use.
Omega-3 supplements
Fats are essential in the building of new cell membranes during wound healing. Although there are good fatty acids to be found in foods like avocados and nuts, one of the most common supplements is omega-3 fish oil.
The omega-3 fatty acids assist in a reduction of inflammation throughout the body. They also assist in cardiovascular health, reducing the risk of blood clots by making platelets less likely to stick together. It has also been shown to aid in age-related memory loss, and researchers have found that there is an inverse relationship between the levels of omega-3 in the blood and depression.
Vitamins
A deficiency in vitamins can have devastating effects on a person of any age, but particularly in an elderly patient. Vitamins of all types are necessary for proper health, but there are several that are absolutely essential for wound healing.
Vitamin A is indispensable for normal growth and differentiation of the skin. It also acts as a hormone on the retinoid receptors of keratinocytes, endothelial cells, fibroblasts, melanocytes, and sebocytes. The presence of vitamin A increases the strength of scar tissue and is also required for an adequate inflammatory response.
Vitamin C is required for the hydroxylation of proline and subsequent collagen synthesis. Vitamin C is important for the proper function of the enzyme protocollagen hydroxylase, which generates collagen; vitamin C forms bonds between the strands of collagen fibers and helps to provide extra strength and stability. It is also essential for the synthesis of the intracellular matrix of tissues such as bone, skin, blood vessel walls, and connective tissue.
Regulating nutritional intake and supplements in wound patients is vital. Without the proper building blocks of proteins, amino acids, fats, and vitamins, the body will become malnourished, breaking down other structures to use as wound-healing instruments. Thus, it is vital to make sure our patients have the best possible nutrition we can provide; and to guarantee that while they are in our care, they are in the best possible hands.
So here’s to your health - and the health of your patients!
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Skilled Wound Care is a mobile surgical practice committed to transforming the chronic wound care model in nursing facilities. Wound care experts make weekly bedside visits to patients in long-term care facilities, avoiding transfers to hospitals or clinics. Our expert physicians give patients the most up-to-date and effective wound treatments, and educate facility staff on how to help patients continue to heal quickly and effectively between visits. This model of collaborative care allows SWC’s physicians to improve patients’ lives and health outcomes, to empower nursing staff, and to raise public awareness. Skilled Wound Care, along with its nurse and nursing home partners, is working every day to positively transform traditional nursing home wound care.