By Jeffrey M. Levine MD, and Michael Cioroiu, MD

Nutrition is an important component of a plan for wound healing. At the Beth Israel Center for Advanced Wound Care, we see all types of wounds, including pressure ulcers, arterial and venous wounds, non-healing surgical wounds and others. Although we have many surgical options and topical treatments, wounds will not heal if the patient is not well nourished. Incorporating a nutritional plan helps achieve the goal of wound healing in the shortest time possible, with minimal pain, discomfort and scarring.

Nutritional Status

We determine a patient’s nutritional status by taking a history and obtaining relevant laboratory values, and an accurate height and weight. Because it is the muscle mass that actively affects metabolism and the body fat that is associated with disease states, Body Mass Index (BMI) is used to estimate body fat. BMI is determined using an equation incorporating height and weight. A nutritional history includes information on such diseases as obesity, diabetes, and malabsorbtion syndromes. Psychological factors such as depression and dementia, and diseases such as cancer and arthritis must also be considered.

Lab Tests

Laboratory tests can be important indicators of nutritional status, but these results can be influenced by non-nutritional factors, as well. The level of serum albumen, for example, is widely considered to reflect the body’s protein stores, but this test is affected by certain kidney and liver diseases. Diabetes is an important nutrition-related disease, and strict control is usually necessary for wound healing. The wound-care physician may order a test for Hemoglobin A1C, which gives information on degree of blood-sugar control.

Healing Process

Wound healing involves a complex series of biochemical interactions. Phases of normal wound healing include hemostasis (the sealing of damaged blood vessels), inflammation, proliferation (tissue rebuilding), and remodeling (forming skin and scar tissue to resemble the original tissue). Each of these phases is distinct but overlapping, and all phases require adequate blood, oxygen and nutrients. Many things take place during these phases, including migration of white blood cells, growth of different types of tissue and skin cells, influx of new capillaries and formation of scar tissue. Proper nutrition is critical for all phases of wound healing.

Essential Nutrients for Proper Wound Healing

Calories, protein and vitamins are the major components necessary for wound healing.

Calories

A calorie is a unit of heat energy, and this is what really fuels our body, just as gasoline fuels your car. Experts have determined that proper wound healing requires 30 calories per kilogram per day, equivalent to 13.6 calories per pound per day. A 150-pound person will therefore need slightly more than 2,000 calories per day to heal a wound.

Protein

Adequate protein also is essential for proper wound healing, and wounds increase the requirement for protein intake. Experts have determined that wound healing requires 1.5 grams of protein per kilogram per day (for a 150-pound person, that’s about 102 grams of protein per day). Proteins are composed of amino acid building blocks, and some experts advise increased intake of specific amino acids, such as arginine or glutamine.

Vitamins

Critical vitamins and minerals important in various phases of wound healing include vitamins A, C, E and zinc. Although a well-rounded diet will supply the requirement for these vitamins, it does not hurt to take supplements when a wound is healing.

Nutrition Is Part of Treatment Plan

At the Beth Israel Center for Advanced Wound Care, we perform nutritional histories on all new patients, and incorporate nutrition into our treatment plan, along with debridements (removal of dead, damaged or infected tissue) and topical dressings. To promote wound healing in the shortest time possible, with minimal pain, discomfort and scarring, it is important not to omit a sensible nutritional approach.

To find an excellent doctor who is right for you, please call our Physician Referral Service at 866.804.1007.

This post was co-authored by guest blogger Michael Cioroiu, MD, Center for Advanced Wound Care and Dr. Levine.