Clinical Observations: Nutritional Status,Nutrition,and Pressure Ulcers

Abstract

Pressure ulcers with a high and increasing prevalence in an aging society have important medical and financial consequences. In subjects with or at increased risk of pressure ulcers, the combination of malnutrition and old age seems highly unpropitious. However, the evidence of malnutrition being a risk factor for pressure ulcers, and nutrition playing a role in the prevention and healing of decubitus is not unanimous. Albeit no causal relationship between nutritional status and the risk of developing pressure ulcers could be established, the impaired intake of energy and protein predisposed to the development of pressure sores. Adequate nutrition was able to reverse the underfed state and seemed to reduce the incidence of decubitus. Adequate energy and protein intake may accelerate the healing of ulcers, but in the case of artificial feeding, the positive effects on wound healing were obscured by the morbidity of tube feeding. None of the specific nutrients such as zinc, vitamin C, and argi-nine consistently promoted the healing of ulcers. Of the many factors involved in the development of pressure ulcers, nutrition might be one of the few reversible host factors. Therefore, the first goal should be to ensure an adequate intake of energy and protein. A second goal should be to correct the nutrient deficiencies of old age as these nutrients are also involved in wound healing. As yet, there is insufficient valid evidence for the use of specifically composed feeds and supplements.