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The role of nutrition in wound healing: an overview

11 March 2021
8 min read
Volume 30 · Issue 5

Abstract

Wounds are a commonly encountered and complex entity in healthcare, and often require multidisciplinary involvement for their management. Wound care and healing are affected by a range of factors of which nutrition, a modifiable factor, plays an integral part. Familiarity with the phases of wound healing and the differing nutritional requirements at each stage is fundamental to managing wounds. Additionally, awareness of the signs of malnutrition, screening tools and educational resources for managing malnutrition in primary care settings are all vital to minimising malnutrition and its adverse effects on wound healing. This article reviews the phases of wound healing and the associated nutritional requirements required for optimal healing, the clinical signs of malnutrition and screening resources for identifying at-risk groups, as well as reviewing current guidelines for managing malnutrition in the inpatient and outpatient setting.

Wound healing is a complex, multistep process influenced by a range of modifiable and non-modifiable risk factors. The failure of hard-to-heal wounds to progress to complete healing has been widely studied, and identifying nutritional status is key to achieving optimal wound resolution.

This article discusses the stages of wound healing, the role of macro- and micronutrients in the wound healing journey and the clinical signs of malnutrition. It also highlights screening tools for high-risk groups as well as resources available for the management of malnourished patients, particularly in community settings.

As defined by the British Association of Parenteral and Enteral Nutrition (BAPEN), malnutrition is a state where there is an imbalance (either deficiency or excess) of energy, protein and other nutrients that adversely affects tissue and bodily functions and clinical outcome (Chen et al, 2001; Johnston, 2007; Cederholm et al, 2017; BAPEN, 2018). Although malnutrition is often considered to be a purely deficient state, it encompasses obesity, and ‘undernutrition’ concerns inadequate nutritional states. For the purposes of this paper, the term ‘malnutrition’ will be used synonymously to mean ‘undernutrition’.

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