Nutrition Guidelines to Improve Wound Healing

Nutrition Improving Your Health with Fiber Smart Choices When Dining Out Stocking a Heart-Healthy Kitchen Helpful Fiber and Protein Suggestions The Fiber Lifestyle Low-Sodium Diet Guidelines Nutrition Guidelines to Improve Wound Healing Nutrition Problems and Their Solutions Probiotics Making Sense of Portion Sizes Cholesterol-Lowering Strategies Healthy Eating for the Digestive System Good nutrition is necessary for healing. During the healing process, the body needs increased amounts of calories, protein, vitamins A and C, and sometimes, the mineral, zinc. The following guidelines will help you choose "power" foods to promote healing.

Goals for healthy eating

Eat a variety of foods to get all the calories, proteins, vitamins, and minerals you need. The Food Pyramid (mypyramid.gov) provides an example of the number of servings you should eat from each food group every day. Remember to select from all food groups daily. If you have a prescribed diet, follow it as much as possible, as it will help promote wound healing and may prevent infection and some complications. Many prescribed diets are based on the recommendations of the Food Pyramid. Food Groups Breads and grains, using whole grain sources as much as possible Vegetables Fruits Dairy Protein Fats and sweets Serving Size 1 slice bread; cup dry cereal; cup cooked cereal, pasta, noodles, or rice 1 cup cooked or raw vegetables; 1 cup raw leafy vegetables cup canned fruit or fruit juice; 1 piece of fruit; cup fresh fruit 1 cup milk or yogurt; 1 ounce cheese 2 3 ounces meat; 1 cup cooked beans or legumes; 1 egg; 2 tablespoons peanut butter Good source of calories but may be restricted by prescribed diet Recommended Serving Sizes

"Power" Foods
Protein: At least 2 to 3 servings per day beef, fish, poultry, pork, veal, lamb, eggs cheese, milk, yogurt dried beans and peas, nuts, seeds Vitamin A: At least 1 serving a day dark green, leafy vegetables orange or yellow vegetables orange fruits fortified dairy products liver Vitamin C: At least 1 serving a day citrus fruits and juices

strawberries, tomatoes peppers, potatoes, spinach some cruciferous vegetables (broccoli, cauliflower, brussel sprouts, cabbage) Zinc: fortified cereals red meats and seafood

If you are not eating well...

1) Eat five or six small meals a day. Instead of trying to eat three big meals a day, try eating smaller meals and snacks between meals to get enough nutrition. Make snacks nutritious. Examples of snacks: cheese and crackers, glass of milk, cottage cheese and fruit, small sandwich, milkshake, peanut butter on crackers or celery, fruit or fruit juices. 2) Use foods that are "nutrient-dense." Some ideas are below:

"Low nutrient-dense" foods

broth plain Jell-O carbonated beverages Italian ice/popsicles

"High nutrient-dense" foods

beef vegetable soup fruited Jell-O milk, milkshakes, ice cream floats, sherbet, ice cream 3) If you have experienced taste changes, try a variety of foods to find out what works for you. You may find that cold foods and foods with little odor work best. For example, cottage cheese, cereals, cheesy entrees such as cheese ravioli and macaroni and cheese, or chicken or tuna salad may be tastier than beef. 4) Use a prepared liquid oral nutritional supplement if nothing else works. These are available in cans at grocery stores, drug stores, and discount chains. All the supplements will vary in taste, so if you dont like the first o ne, try another brand. Also, adding milk or ice cream may make the supplement tastier. 5) Take a multivitamin if you are unable to meet the guidelines of the Food Pyramid. You will need a special multivitamin if your kidneys are impaired.

If you have diabetes or high blood sugar...

Continue to monitor your blood sugar levels closely. Having good control of blood sugar levels will help with wound healing and may prevent infection. You may need to visit your doctor and a registered dietitian to help control blood sugar through diet and medication.

Finally
Make an appointment with a registered dietitian if your appetite remains poor, your wound is not healing well, and/or you are losing weight.

How Your Diet Can Aid In Wound Healing

Without proper nutrition, the whole process of wound healing can be negatively impacted. Your diet during recovery plays a critical role in how fast your wound heals, how strong the wound tissue becomes, the duration of the recovery period and how well your body fights off infection. A poor diet can turn a normal wound into a chronic wound that never seems to be get better.

The Catabolic Phase

Even a small wound can alter the way your body metabolizes nutrients. As the body attempts to heal itself from a wound, it will create stress hormones and divert extra resources carbohydrates, fats, proteins, antioxidants and more to the creation of new tissue. This is referred to as the catabolic phase of healing. Your metabolism essentially speeds up during this process. If the catabolic phase drags on too long, protein energy malnutrition (PEM) can set in. This begins a negative cycle which slows wound healing and deteriorates your health. Your body sends extra protein to deal with the wound and, as a consequence, other important body systems and organs don't receive enough protein. This leads to reduced muscle mass and delayed wound healing.

Proper Nutrition in Wound Healing

Protein is the most important aspect of your diet when healing from a wound. Energy (calories from carbohydrates and fats), amino acids, antioxidants and minerals (zinc) are also important. Your dietary needs will be calculated on an individual basis, and your doctor or nutritionist may adjust the levels of each nutrient to facilitate healing. The following guidelines are only generalizations, but will give you an idea of what your diet should include.

Protein
Protein helps repair the damaged tissue from your wound. You'll want to take in more protein than usual to help the healing process. This means 2 to 3 servings of protein a day, with each serving containing at least 2 to 3 ounces of meat (1 cup of beans or 2 tablespoons of peanut butter are alternatives). Your doctor will want to monitor your diet closely. If you don't take in enough calories, the body might convert more of your body's protein to energy instead of healing.

Fats
Fats from dairy products are essential for wound healing. Cell membranes are created with the use of fatty acids, and you'll need to take in extra sources of these to maintain healing. Cooking oils and meats are also a good source of fats. One cup of milk or yogurt or an ounce of cheese would be good examples of how much you should include in your daily diet during the healing process.

Carbohydrates
Taking in plenty of carbohydrates is essential, to prevent the body from using other nutrients and protein for energy. Cereals, breads, rice and pasta are good sources of energy, and should be included in your daily diet.

Vitamin C
Vitamin C is an important antioxidant for wound healing. It increases the strength of the wound as it heals, and it helps with the creation of collagen in the skin. Vitamin C is also important in the creation of new blood vessels, and it helps with iron absorption. Citrus fruits and leafy green vegetables are great sources of vitamin C. You should be taking in up to 200 mg of vitamin C daily, which is fairly easy with at least one serving of these foods per day.

Vitamin A
Vitamin A is another crucial antioxidant. The body needs additional vitamin A to help with wound healing. It can help fight off infection, and aids in controlling the inflammatory response. Vitamin A levels have to be monitored closely, because toxicity can occur if too much is consumed. Red fruits and vegetables, eggs, fish and dark green vegetables are all good sources of vitamin A.

Zinc
Zinc helps the body synthesize proteins and develop collagen, so it is an important mineral for wound healing. As long as you are taking in sufficient amounts of protein from meats, you should be getting enough zinc in your diet. The level recommended by your doctor will vary from 15 to 50 mg per day. Take extra care to follow your physician's dietary advice, especially if it is a prescribed diet. Diabetic patients will have additional considerations when devising a nutritional plan with their doctor. A final note is needed to emphasize the importance of hydration for wound healing. Drink plenty of water and fluids throughout the healing process to help facilitate proper circulation and detoxification.

Read more: http://www.woundcarecenters.org/living-with-wounds/how-your-diet-can-aid-in-woundhealing.html#ixzz2PBk9qIep

Wound Healing And Your Diet

Why is a healthy diet important for wound healing?
Wound Healing And Your Diet Care Guide

Wound Healing And Your Diet Wound Healing And Your Diet Aftercare Instructions Wound Healing And Your Diet Discharge Care En Espanol

Your body uses nutrients from a healthy diet to help fight infection and heal wounds. Wounds may be caused by injury, incisions (cuts) made during surgery, or pressure ulcers. Pressure ulcers (sores) on your skin can form when there is pressure or rubbing. In the early stages of a pressure ulcer, the ulcer may be an area of reddened skin that does not go away. In later stages, the skin breaks and the wound becomes deep. People with diabetes or blood flow problems have a higher risk of getting pressure ulcers. People who stay in the same position for long periods of time are also more likely to get pressure ulcers. This includes people who use a wheelchair or who need to stay in bed. How fast and how well your wound heals depends on many things. There is no special diet that will heal your wound. However, studies have found that healing takes longer in people who follow a poor diet. A poor diet is one that is very low in calories or important nutrients. Wound healing also takes longer in people who are not eating well while their wounds are healing. Nutrients that are most important for healing are protein, zinc, and vitamin C. Drinking enough liquids each day is also important for wound healing.

What are ways to include more healthy foods in my diet?

Eat a variety of foods from each food group every day. The food groups include breads and starches, vegetables, fruits, meats and protein foods, and dairy. Eat regular meals and snacks to help you eat enough servings from each food group. If you have trouble eating three meals each day, eat 5 to 6 small meals throughout the day instead. Include good sources of protein, zinc and vitamin C in your diet each day. Drink plenty of liquids during and between meals, unless your caregiver has told you to limit your liquid intake. Limit foods that are high in fat, sugar, and salt. Some foods that are high in fat and sugar are doughnuts, cookies, fried foods, candy, and regular soda. These foods are unhealthy choices because they are low in healthy nutrients that are important for healing.

What foods are good sources of protein?

Foods that are high in protein are listed below. The average protein content of each food is listed in grams beside the name of the food. The protein content may vary slightly between brands of each food. Read the labels of packaged items like protein powders to find the amount of protein in them. Ask your caregiver how much protein you need in your diet each day.
o o o o o o o o o o o o o

Dairy: One cup of any type of fresh milk (8). One-fourth cup of nonfat dry milk (11). One ounce of semi-hard or solid cheese (7). One-half cup of cottage cheese (14). One-half cup of pudding (4). Eight ounces of plain or fruit yogurt (8). Meats and meat substitutes: Three ounces of cooked fresh water fish (21). One-half cup of canned tuna (14). Three ounces of cooked shellfish (19). Three ounces of cooked chicken, turkey, or other poultry (24). Three ounces of cooked beef, pork, lamb or other red meat (21). One large egg (6). One-half cup of tofu or tempeh (10).

o o o o o

One cup of soy milk (4). One cup of cooked dried beans, like pinto, kidney, or navy (15). Nuts and seeds: Two tablespoons of almonds, cashews, or walnuts (5). Two tablespoons of peanut butter (8). Two tablespoons of peanuts (7).

How can I add extra protein to the foods in my diet?

You can increase the amount of protein in your diet by adding extra protein to your dishes or drinks.

Powdered milk added to whole milk, pudding, yogurt or baked goods. Protein powders added to drinks or moist foods. Cheese added to sandwiches, omelettes, burritos, or beans. Low-fat milk added to omelettes. Nuts and peanut butter added to cookies. Extra cheese or eggs added to casseroles. Meat added to lasagna or spaghetti. Yogurt and milk added to fruit smoothies. Beans and cheese added to salads. Cheese added to vegetables or potatoes.

What foods are good sources of vitamin C?

Vitamin C is found in fruits and vegetables. Fruits such as oranges, strawberries, grapefruit, cantaloupe, and tangerines are good sources of vitamin C. Red and green bell peppers, broccoli, potatoes, tomatoes, and cabbage are also high in vitamin C.

What foods are good sources of zinc?

Good sources of zinc are beef, liver and crab. Smaller amounts of zinc are found in sunflower seeds, almonds, peanut butter, eggs and milk. Other foods that contain zinc include wheat germ, blackeyed peas, and whole-grain products.

How much liquid do I need each day?

Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Water, beverages, and water found in solid foods count towards this daily liquid amount. Good choices for most people to drink include water, juice, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Food items such as soup, fruit, and vegetables also add liquid to your diet. Ask your caregiver how much liquid you should drink each day.

What other diet changes may be needed?

Some people are not able to eat enough food to get the nutrients they need. If you are not getting enough nutrients, your caregiver may suggest that you take a multivitamin or another supplement. He may also suggest that you drink nutrition supplements for extra protein and calories. These can be bought in most grocery stores.
PHASES OF WOUND HEALING
Whether wounds are closed by primary intention, subject to delayed primary closure or left to heal by secondary intention , the wound healing process is a dynamic one which can be divided into three phases. It is critical to remember that wound healing is not linear and often wounds can progress both forwards and back through the 2 phases depending uponintrinsic and extrinsic forces at work within the patient . The phases of wound healing are :
2 1

Inflammatory phase Proliferation phase Maturation phase The inflammatory phase is the bodys natural response to injury. After initial wounding, the blood vessels in the wound bed contract and a clot is formed. Once haemostasis has been achieved, blood vessels then dilate to allow essential cells; antibodies, white blood cells,growth factors, enzymes and nutrients to reach the wounded area. This leads to a rise inexudate levels so the surrounding skin needs to be monitored for signs of maceration. It is at this stage that the characteristic signs of inflammation can be seen; erythema, heat, oedema, pain and functional disturbance. The predominant cells at work here are the phagocytic cells; neutrophils and macrophages; mounting a host response andautolysing any devitalised necrotic / sloughy tissue. During proliferation, the wound is rebuilt with new granulation tissue wh ich is comprised of collagen and extracellular matrix and into which a new network of blood vessels develop, a process known as angiogenesis. Healthy granulation tissue is dependent upon the fibroblast receiving sufficient levels of oxygen and nutrients supplied by the blood vessels. Healthy granulation tissue is granular and uneven in texture; it does not bleed easily and is pink / red in colour. The colour and condition of the granulation tissue is often an indicator of how the wound is healing. Dark granulation tissue can be indicative of poor perfusion, ischaemia and / or infection. Epithelial cells finally resurface the wound, a process known as epithelialisation. Maturation is the final phase and occurs once the wound has closed. This phase involves remodelling of collagen from type III to type I. Cellular activity reduces and the number of blood vessels in the wounded area regress and decrease. Other sections available:-

WHAT IS A WOUND? 1 A wound may be described in many ways; by its aetiology, anatomical location, by whether it is acute or chronic , by the method of closure, by its presenting symptoms or indeed by the appearance of the predominant tissue types in the wound bed. All definitions serve a critical purpose in the assessment and appropriate management of the wound through to symptom resolution or, if viable, healing. A wound by true definition is a breakdown in the protective function of the skin; the loss of continuity of epithelium, 2 with or without loss of underlying connective tissue (i.e. muscle, bone, nerves) following injury to the skin or underlying tissues/ organs caused by surgery, a blow, a cut, chemicals, heat/ cold, friction/ shear force, pressure or 3 as a result of disease, such as leg ulcers or carcinomas . Wounds heal by primary intention or secondary intention depending upon whether the wound may be closed with sutures or left to repair, whereby damaged tissue is restored by the formation of connective tissue and re-growth of epithelium Other sections available:4

The skin is one of the largest organs in the body in surface area and weight. The skin consists of two layers: the epidermis and the dermis. Beneath the dermis lies the hypodermis or subcutaneous fatty tissue. The skin has three main functions: protection,regulation and sensation. Wounding affects all the functions of the skin. The skin is an organ of protection. The primary function of the skin is to act as a barrier. The skin provides protection from: mechanical impacts and pressure, variations in temperature, micro-organisms, radiation and chemicals. The skin is an organ of regulation. The skin regulates several aspects of physiology, including: body temperature via sweat and hair, and changes in peripheral circulation and fluid balance via sweat. It also acts as a reservoir for the synthesis of Vitamin D. The skin is an organ of sensation. The skin contains an extensive network of nerve cells that detect and relay changes in the environment. There are separate receptors for heat, cold, touch, and pain. Damage to these nerve cells is known as neuropathy, which results in a loss of sensation in the affected areas. Patients with neuropathy may not feel pain when they suffer injury, increasing the risk of severe wounding or the worsening of an existing wound.