Dietary Intake in: Clients with Chronic Wounds

Abstract

To assess relationships among food intake, anthropometrics, and wound severity, we studied 31 home care clients with pressure ulcers (PUs) or venous stasis ulcers (VSUs). Anthropometric variables (weight, height, waist circumference [WC]) were measured according to standard methodologies. Risk for PU development was assessed using the Braden Pressure Ulcer Risk Assessment score and wound severity according to the National Pressure Ulcer Advisory Panel. Three-day food records were analyzed to assess dietary adequacy. Adults with VSUs (65.8 ± 18.4 years) had a higher body mass index (48.1 vs. 25.9), WC (146.6 vs. 98.4 cm), and Braden score (20.2 vs. 17.5) than did those with PUs (67.8 ± 17.9 years) (p <0.05). Energy, protein, and zinc intake by diet alone did not meet estimated requirements in 41%, 32%, and 54.5% of clients, respectively. Intake by diet alone met the Estimated Average Requirement/Adequate Intake for all nutrients except fibre, vitamin D, vitamin E, vitamin K, folate, calcium, magnesium, and potassium. Nutrient supplementation resolved this for all nutrients except fibre, vitamin K, and potassium. In multivariate analysis, increasing wound severity was associated with decreased intakes of vitamin A, vitamin K, magnesium, and protein (r2=0.90, p<0.001). Optimizing nutrient intake may be an important strategy to promote wound healing and decrease wound severity in home care clients with chronic wounds.

Effects and associations of nutrition in patients with venous leg ulcers: A systematic review

“…All participants had ulcers classified by the CEAP classification as C5 or C6. Six studies reported patient comorbidities, which included diabetes mellitus, arterial hypertension, chronic heart failure and cardiovascular disease (Abbade et al., , ; Apollonio et al., ; Legendre et al., ; McDaniel et al., ; Wojcik et al., ). Sample sizes of included studies were generally small with a median size of 84, ranging from 2 to 639.…”

“…In eight of the 13 studies reporting weight status, the majority of VLU patients were found to have a BMI >25 (Table ) (Abbade et al., , ; Finlayson et al., ; McDaniel et al., ; Serra et al., ; Tobon et al., ; Vines et al., ; Wojcik et al., ). Of the seven studies that measured obesity exclusively, prevalence ranged from 21.8‐81.8% of participants (Abbade et al., ; Apollonio et al., ; De Franciscis et al., ; Legendre et al., ; McDaniel et al., ; Tobon et al., ; Vines et al., ).…”

“…One study employed a case-series design (Apollonio et al, 2016). Eight studies were cross-sectional (Abbade, Lastoria, & Rollo Hde, 2011;Abbade et al, 2005;Burkievcz et al, 2012;Finlayson, Edwards, & Courtney, 2009;McDaniel, Kemmner, & Rusnak, 2015;Tobon, Whitney, & Jarrett, 2008;Vines, Gemayel, & Christenson, 2013;Wojcik, Atkins, & Mager, 2011). Three were case-control studies (Durmazlar, Akgul, & Eskioglu, 2009;Legendre et al, 2008;Szewczyk et al, 2008) and three were quasi-experimental studies (Burkiewicz et al, 2012;De Franciscis et al, 2015;Serra et al, 2016).…”

“…Sample sizes of included studies were generally small with a median size of 84, ranging from 2 to 639. Despite several studies having larger participant numbers, low-level CEAP classifications of venous disease or ulcers of mixed aetiology were included (Apollonio et al, 2016;Durmazlar et al, 2009;Raffoul et al, 2006;Vines et al, 2013;Wojcik et al, 2011). Only a subset of these participants met the inclusion criteria (Table 1).…”

“…Ten studies were located in Europe (Milic et al, 2009) (Apollonio et al, 2016;De Franciscis et al, 2015;Hjerppe et al, 2010;Krejner et al, 2016;Legendre et al, 2008;Raffoul et al, 2006;Serra et al, 2016;Szewczyk et al, 2008;Vines et al, 2013), one in Turkey (Durmazlar et al, 2009), four in South America (Abbade et al, 2005(Abbade et al, , 2011Burkievcz et al, 2012;Burkiewicz et al, 2012), one in Australia (Finlayson et al, 2009) and four in North America (Labropoulos et al, 2012;McDaniel et al, 2015;Tobon et al, 2008;Wojcik et al, 2011).…”