Optimising healing through enteral and parenteral nutrition in critical illness

Wound care in the intensive care unit (ICU) is a multifaceted challenge. These patients often experience complex wounds, such as pressure ulcers, surgical wounds, or trauma-related injuries, which require meticulous care. Although local wound management is essential, an equally important, yet sometimes underemphasised, component of effective wound care in these settings is proper nutritional support. Critical illness often induces a hypermetabolic state, catabolic stress, and immune dysfunction, all of which can impair wound healing. This article examines the significant role that nutrition, specifically via enteral nutrition (EN) and total parenteral nutrition (TPN) routes, plays in promoting wound healing and improving patient outcomes in the ICU.

Adequate nutrition is integral to wound healing, a process that relies on the availability of critical nutrients such as proteins, vitamins, and minerals. These nutrients are essential for tissue repair, collagen synthesis, and immune function. In the ICU, critically ill patients are often at risk of malnutrition due to a variety of factors, including prolonged fasting, catabolism, and gastrointestinal dysfunction (Peate and Hill, 2022). Nutritional deficiencies can lead to delayed wound healing, increased risk of infection, and longer recovery times.