Diet for patients with wounds
Proper nutrition is of key importance in wound healing. Optimal supply of energy, nutrients, vitamins, proteins, carbohydrates, fiber and mineral salts play a nutritional and regenerating role whereas herbs stimulate the immune system and have cleaning and antibacterial properties. The selection of dietary elements is individually determined by the type of wound, whether it is diabetes-induced or post traumatic or a result of cancer. The diet in wound management is also dependent on gender, age, physical activity, general health status and co-morbidities. Sufficient hydration with 1,5-2 l of liquids is a basic requirement for effective wound healing.
Carbohydrates and fats are the main sources of energy and the energy required to maintain the body’s normal activities is referred to as basal energy expenditure and amounts to 25-35 kcal/kg/d.
Carbohydrates are the main energy source for blood, especially red blood cells, muscles, brain and bone marrow and we can find them in cereals, whole grain bread, legumes, potatoes and some vegetables and fruit.
Proteins, in turn, support wound healing process by affecting the granulation tissue formation (new skin), oxygen transport, new cell proliferation and the secretion of hormones which influence biochemical processes.
Fats provide energy for tissues and organs and serve as structural material. The demand for fats amounts to 20-30% of daily energy needs, while 6-10% of total energy from food consumption should be covered by polyunsaturated fats. Fats can be found in milk, meat, butter, cheese and yoghurt. Omega-3 fatty acids from fish and squid oil as well as olive oil are also a good dietary supplementation.
We should not underrate phytotherapy (medicinal use of herbs) and apitherapy (medicinal use of honey) in wound healing as they have been used to support treatment since Ancient Times. A wide variety of honey types proved their wide range of applications and good results in wound healing promotion. As a natural antibiotic and probiotic, honey can be used in chronic conditions. Honey and its products have been documented to eliminate bacteria colonized in the wound and when applied orally eradicate such bacteria as streptococcus, staphylococcus and fungi. Manuka honey is the kind of such properties.
Vitamins are organic compounds that are necessary to maintain functioning of many systems and play a significant role in wound healing process. Vitamin A has an antioxidative function, stimulates healing mechanisms and affects susceptibility to infections. It occurs in dairy products, egg yolk, tomato, pepper and parsley. The B complex vitamins function as enzyme cofactors which participate in healing processes and increase immunity. Vitamin B2 and B6 prevent skin changes, vitamin B3 decreases cholesterol level and vitamin B12 prevents anemia. The products rich in these vitamins include: fish, oat flakes, groats, nuts and seeds.
Vitamin C plays an important role in the immune system stimulation and increases iron absorption. The demand for vitamin C is increased in the case of severe chronic wounds, ulcerations and bed ulcers, when the risk of systemic infection is higher. Rose hips, citrus fruit, esp. grapefruit, tomatoes, strawberries, sour cabbage and broccoli are a good source of vitamin C. Vitamin K is of vital importance for blood coagulation, electrolyte and acid base balance and regulation of minerals supply e.g. potassium, calcium, sodium, magnesium and phosphorus.
Providing all the diet compounds which are required daily poses a problem in the diseased and the elderly. Lack of appetite, chewing problems, pain and depression often afflict patients with chronic or severe wounds and cause their unwillingness to consume food. Therefore, it is advisable to complement the daily food intake with minerals and vitamin supplementation in an easy to apply form of capsules, liquids or soluble powders.
Individual consultation with a doctor and a dietitian is an extremely important element of a diet management.