Did you know that dietary care provided by a dietitian can assist with the management of wound healing and pressure injuries?

The skin is the largest organ of the body and undergoes significant changes during the ageing process. As the layers of the skin change, its normal function as a barrier to infection, protection, temperature, and water regulation are affected.

These changes make older adults more susceptible to damage from moisture, friction, or trauma.

The incidence of skin tears, pressure injuries, chronic leg ulcers and diabetic foot ulcers increases with age and therefore need to be managed closely.

Good nutrition is essential for optimal health and wellbeing for older adults in Aged Care Facilities. Poor nutrition can result in a number of complications, including weight and muscle loss, poor skin integrity, reduced mobility, and infections.

Poor skin integrity can increase the risk of residents developing pressure injuries and wounds. Nutrition plays an essential role in wound healing and should be considered as a fundamental part of wound management in aged care.

Key Dietary Nutrients for Wound Healing:

• Protein: essential for the maintenance and repair of body tissue. Depleted protein will slow the wound healing process. Sources: meat, chicken, fish, eggs, dairy products, lentils and legumes, nuts and seeds, tofu. It is recommended that individuals with wounds consume 1.2-1.5g/kg of protein per day.
• Energy: individual energy requirements increase depending on the size and complexity of the wound. Sources: wholegrain bread and cereal, pasta, rice, potato, biscuits, meat, milk, cheese, butter, cream, yoghurt, oils, and margarine. It is recommended that individuals with wounds consume 30-35kcal of energy per kilogram of ideal body weight.
• Zinc: key role in tissue growth and healing. Sources: red meat, fish, milk products, chicken, and eggs.
• Iron: provides oxygen to the site of the wound to assist healing. Sources: red meat, offal, fish, eggs, dark green leafy vegetables, dried fruit, nuts, and yeast extracts (e.g., Vegemite).
• Vitamin C: important for forming new blood vessels, immune health, and absorption of iron. Sources: fruit and vegetables (particularly oranges, tomatoes, and leafy vegetables).

Hydration is also essential in wound care

Dehydrated skin is less elastic and more susceptible to breakdown. Dehydration also reduces blood flow, impairing the supply of oxygen and other nutrients to the wound.

The European Society of Parental and Enteral Nutrition recommended women consume at least 1.6L per day and men at least 2L per day.

Arginine is an amino acid (a building block of protein) which has been found to be essential for wound healing.

For chronic wounds that aren't healing, an arginine enriched nutritional supplement in addition to a high energy, high protein diet is recommended.

Supplementation in Aged Care Facilities:

Wound specific supplements such as Arginiad, Arginaid Extra, Cubitan and Enprocol Repair can be used to support chronic and slow healing wounds.

These supplements contain Arginine, Zinc and Vitamin C to promote wound healing. Wound specific supplements need to be used for a minimum of 2 weeks.

Not all wound supplements are the same. A Dietitian can help you choose the right dose and wound supplement for your residents.

Overall, good nutrition is essential for optimal health and well-being for wound care.

Nutrition for wound healing includes eating a variety of foods from each of the five food groups (breads and cereals, fruit, and vegetables, dairy and alternatives and lean meats, fish, poultry, legumes, and alternatives.

However, for some individuals it may not be possible to achieve adequate levels of essential nutrients specific for wound care through regular food intake alone.

In these cases, the use of oral nutritional supplementation may be beneficial and has been shown to support wound care.

Always consult your Dietitian and medical team when deciding which option is most suitable for you or the older adults in your care. Your Food Solutions Dietitian is available to help.