Liječnički vjesnik, Vol. 146 No. 7-8, 2024.
Professional paper
https://doi.org/10.26800/LV-146-7-8-1
Guidelines for nutrition support in chronic wounds
Miljenko Kovačević
*
Pave Gospodnetić
Darija Vranešić Bender
Sanja Radanac
Aleksandra Munjiza
Krešimir Martinac
Zdravka Poljaković
Ante Kanjer
Predrag Pavić
Vedran Pažur
Tajana Pavić
Ana Lamza
* Corresponding author.
Abstract
Chronic wounds are wounds of various etiologies that do not heal within a period of 6–8 weeks. In patients with a chronic wound, the normal physiology of linear healing turns into a pathological chronic cycle of “vicious circle”, without a clear endpoint of wound closure. The wound healing process can be impaired by numerous factors, both systemic and local. The modern approach to the patient with a chronic wound requires an interdisciplinary approach considering the different etiologies of the wound. Malnutrition can slow wound healing
and increase the risk of a chronic course despite modern local techniques. Moreover, the presence of an inflammatory response associated with a chronic wound increases the loss of body cell mass and causes anabolic resistance. The nutritional status of the patient plays a key role in wound healing, and special importance is given to the adequate intake of energy, protein, specific essential and conditionally essential nutrients, and hydration of the patient. The recommended energy intake of malnourished patients at risk of chronic wounds and decubital ulcers is 30–35 kcal/kg/day, while the recommended protein intake is 1.2–1.5 g/kg/day. These recommendations are general and should be adjusted for each patient, depending on age, nutritional status, comorbidities, degree, size and number of wounds and kidney function. Some specific nutrients that participate in the wound healing process have been recognized, especially proteins, glutamine, arginine, HMB, zinc, selenium, copper, iron and vitamins A, C and D. The aim of these guidelines is to present a recommended screening and monitoring algorithm and to introduce a specific nutritional therapy in patients with chronic wounds. The guidelines also show the specifics of nutritional therapy for burns, surgical wounds, diabetic foot, and special approach to neurological and geriatric patients.
Keywords
WOUNDS AND INJURIES – etiology, therapy; CHRONIC DISEASE; WOUND HEALING – physiology; NUTRITIONAL STATUS; NUTRITIONAL REQUIREMENTS; NUTRITION THERAPY; DIABETIC FOOT – therapy; VARICOSE ULCER – therapy; PRESSURE UCER – therapy; BURNS – therapy; NUTRITIONAL SUPPORT; COMBINED MODALITY THERAPY; PATIENT CARE TEAM; PRACTICE GUIDELINES AS TOPIC
Hrčak ID:
320252
URI
Publication date:
30.8.2024.
Visits: 0 *