References

Acton C. The importance of nutrition in wound healing. Wounds UK. 2013; 9:(3)61-64

Bloom I, Edwards M, Jameson KA Influences on diet quality in older age: the importance of social factors. Age Ageing. 2017; 46:(2)277-283

Bold J. Supporting evidence–based practice in nutrition and hydration. Wounds UK. 2020; 16:(2)22-28

BAPEN. Malnutrition Universal Screening Tool (MUST). 2011. http://www.bapen.org.uk/pdfs/must/must_full.pdf (accessed 8 June 2022)

British Nutrition Foundation. NDNS: Time trend and income analyses for years 1 to 9. 2019. https://bit.ly/2yEIFbe (accessed 8 June 2022)

Brito PA, Generoso SV, Correia MITD. Prevalence of pressure ulcers in hospitals in Brazil and association with nutritional status—a multicenter, cross-sectional study. Nutrition. 2013; 29:(4)646-649 https://doi.org/10.1016/j.nut.2012.11.008

Cawood AL, Elia M, Stratton RJ. Systematic review and meta-analysis of the effects of high protein oral nutritional supplements. Ageing Res Rev. 2012; 11:(2)278-296 https://doi.org/10.1016/j.arr.2011.12.008

Cereda E, Neyens JCL, Caccialanza R, Rondanelli M, Schols JMGA. Efficacy of a disease-specific nutritional support for pressure ulcer healing: a systematic review and meta-analysis. J Nutr Health Aging. 2017; 21:(6)655-661 https://doi.org/10.1007/s12603-016-0822-y

Cox J, Rasmussen L. Enteral nutrition in the prevention and treatment of pressure ulcers in adult critical care patients. Crit Care Nurse. 2014; 34:(6)15-28 https://doi.org/10.4037/ccn2014950

Department of Health and Social Care. Safeguarding adults protocol: pressure ulcers and the interface with a safeguarding enquiry. 2018. https://tinyurl.com/5fs8fcke (accessed 8 June 2022)

Elia M, Normand C, Laviano A, Norman K. A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community and care home settings. Clin Nutr. 2016; 35:(1)125-137 https://doi.org/10.1016/j.clnu.2015.07.012

European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressure ulcers/injuries. 2019. https://internationalguideline.com/static/pdfs/Quick_Reference_Guide-10Mar2019.pdf (accessed 9 June 2022)

Guest JF, Ayoub N, McIlwraith T Health economic burden that different wound types impose on the UK's National Health Service. Int Wound J. 2017; 14:(2)322-330 https://doi.org/10.1111/iwj.12603

Langer G, Fink A. Nutritional interventions for preventing and treating pressure ulcers. Cochrane Database Syst Rev. 2014; (6) https://doi.org/10.1002/14651858.CD003216.pub2

Medlin S. Nutrition for wound healing. Br J Nurs. 2012; 21:(12)S11-S15 https://doi.org/10.12968/bjon.2012.21.Sup12.S11

Mitchell A. Adult pressure area care: preventing pressure ulcers. Br J Nurs. 2018; 27:(18)1050-1052 https://doi.org/10.12968/bjon.2018.27.18.1050

Molnar JA, Underdown MJ, Clark WA. Nutrition and chronic wounds. Adv Wound Care. 2014; 3:(11)663-681 https://doi.org/10.1089/wound.2014.0530

Moor F. Role of nutrition in pressure ulcer management. Journal of Community Nursing. 2019; 33:(1)38-41

Munoz N, Posthauer ME, Cereda E, Schols JMGA, Haesler E. The role of nutrition for pressure injury prevention and healing: the 2019 International Clinical Practice Guideline recommendations. Adv Skin Wound Care. 2020; 33:(3)123-136 https://doi.org/10.1097/01.ASW.0000653144.90739.ad

National Institute for Health and Care Excellence. Pressure ulcers: prevention and management Clinical guideline CG179. 2014. https://www.nice.org.uk/Guidance/CG179/ (accessed 9 June 2022)

Neyens J, Cereda E, Rozsos I Effects of arginine-enriched oral nutritional supplement on the healing of chronic wounds in non-malnourished patients; a multifactor case series from the Netherlands and Hungary. Journal of Gerontology & Geriatric Research. 2017; 6:(2)

NHS Improvement. Pressure ulcer core curriculum. 2018. https://tinyurl.com/34fyvdv7 (accessed 9 June 2022)

Pierpont YN, Dinh TP, Salas RE Obesity and surgical wound healing: a current review. ISRN Obes. 2014; 2014:1-13 https://doi.org/10.1155/2014/638936

Posthauer ME, Banks M, Dorner B, Schols JMGA. The role of nutrition for pressure ulcer management: National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance white paper. Adv Skin Wound Care. 2015; 28:(4)175-190 https://doi.org/10.1097/01.ASW.0000461911.31139.62

Pribyl M. Nutrition and pain: building resilience through nourishment. Orthopaedic Physical Therapy Practice. 2018; 30:(4)562-564

Quain AM, Khardori NM. Nutrition in wound care management: a comprehensive overview. Wounds. 2015; 27:(12)327-335

Roberts S, Desbrow B, Chaboyer W. Feasibility of a patient-centred nutrition intervention to improve oral intakes of patients at risk of pressure ulcer: a pilot randomised control trial. Scand J Caring Sci. 2016; 30:(2)271-280 https://doi.org/10.1111/scs.12239

Saghaleini S, Dehghan K, Shadvar K, Sanale S, Mahmoodpoor A, Ostadi Z Pressure ulcer and nutrition. Indian Journal of Critical Care Medicine. 2018; 22:(4)283-289 https://doi.org/10.4103/ijccm.IJCCM_277_17

Sherman AR, Barkley M. Nutrition and wound healing. J Wound Care. 2011; 20:(8)357-8 https://doi.org/10.12968/jowc.2011.20.8.357

Soleimani Z, Hashemdokht F, Bahmani F, Taghizadeh M, Memarzadeh MR, Asemi Z. Clinical and metabolic response to flaxseed oil omega-3 fatty acids supplementation in patients with diabetic foot ulcer: a randomized, double-blind, placebo-controlled trial. J Diabetes Complications. 2017; 31:(9)1394-1400 https://doi.org/10.1016/j.jdiacomp.2017.06.010

Theilla M, Schwartz B, Zimra Y Enteral n-3 fatty acids and micronutrients enhance percentage of positive neutrophil and lymphocyte adhesion molecules: a potential mediator of pressure ulcer healing in critically ill patients. Br J Nutr. 2012; 107:(7)1056-1061 https://doi.org/10.1017/S0007114511004004

Tuz MA, Mitchell A. The influence of anaemia on pressure ulcer healing in elderly patients. Br J Nurs. 2021; 30:(15)S32-S38 https://doi.org/10.12968/bjon.2021.30.15.S32

Wounds UK. Best practice statement. Effective exudate management. 2013. https://tinyurl.com/jjjuc4yw (accessed 9 June 2022)

The impact of nutrition on pressure ulcer healing

23 June 2022
Volume 31 · Issue 12

Abstract

Pressure ulcers are debilitating and often painful problem, particularly in people who are elderly, immobile and/or obese. It is estimated that more than 100 000 new pressure ulcers develop each year. These wounds are caused by friction and shear and are particularly prevalent in older people, where malnutrition can be a factor in their development. Nutrition plays a key role in pressure ulcer care because wounds need both macronutrients and micronutrients to heal. It is essential that nurses understand the role of nutrition in pressure ulcer management.

It is estimated that 110 000 new pressure ulcers develop each year (Department of Health and Social Care, 2018), costing the NHS between £1.4 and £2.1 billion annually (European Pressure Ulcer Advisory Panel (EPUAP) et al, (2019). The average length of a hospital stay for a patient with a pressure ulcer is around 25 days (NHS Improvement, 2018).

Pressure ulcers are caused by tissue damage when the blood supply to an area of skin is impaired because of significant pressure; they are often preventable (National Institute for Health and Care Excellence (NICE), 2014). Clinical interventions for pressure ulcer prevention include holistic assessment, risk assessments and preventive measures (Mitchell, 2018). Malnutrition is a common complication in wound healing and has been cited as a key factor in the development of pressure ulcers (NICE, 2014).

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content