II. Pathophysiology
-
Malnutrition impedes Wound Healing
- Weight loss over 15 to 25% of body weight
- Protein depletion
-
Vitamin Deficiency impedes Wound Healing
- Vitamin C Deficiency (Scurvy is a dramatic example)
- Vitamin A Deficiency
- Zinc Deficiency
III. Precautions
- No significant evidence supports Nutritional Supplementation for Pressure Ulcer prevention or management
IV. Management: Assess Adequate Dietary Intake
- Adequate Protein intake and calorie intake
- Adequate fluid intake
V. Management: Perform nutritional assessment every 3 months
- Serum Albumin <3.5 grams
- Lymphocyte Count <1500
- Low Total Cholesterol (<100 suggests Malnutrition)
- Diminshed oral intake
- Weight change
VI. Management: Malnourished with continued inadequate intake
- Consider Tube Feeding for Positive Nitrogen Balance
- Calories: 30-35 kcal/kg/day
- Protein: 1.25-1.50 grams/kg/day
- Vitamin And Mineral supplementation
VII. Management: Unsupported Vitamin Supplementation (possible efficacy)
- Vitamin C 500 mg PO bid
- Iron Supplementation
- Zinc supplementation