Pressure Ulcers & Nutrition

Pressure ulcers are a major issue in hospitals and long term care facilities. Pressure ulcers are caused by lying in bed or using a wheel chair continuously for an extended period of time. The skin will rub against the bed or chair at certain points. Pressure impedes the capillary blood flow to the skin. Pressure ulcers may be prevented by rotating body position frequently. Mattress covers of varying thickness also help in prevention.

Types

• Although pressure ulcers can occur anywhere, common places for pressure are the lower back, heels of feet and back of the head. Pressure ulcers occur in five stages. The first stage is redness of the skin in areas at risk for pressure ulcers. This can be seen as a warning sign to begin prevention methods. Change body position in order to allow at risk areas to have no weight to support. Stage five is the most severe stage where the pressure ulcer may wear the skin down to the bone.

Protein

• If a person with pressure ulcers is not consuming adequate protein the tissue is not able to regenerate and heal the ulcer. Pressure ulcers also increase protein needs. Protein needs are determined by the stage of the ulcer. Stage one pressure ulcers have average protein needs, which is about 0.8 - 1.0 gram protein per kilogram. A large stage five ulcer may require 2.0 - 2.5 grams protein per kilogram body weight in order to heal. Existence of other diseases and conditions will effect protein needs.

Vitamins

• Vitamin C and zinc supplementation is recommended for people with pressure ulcers. Vitamin C helps to rebuild collagen, which is part of skin. Zinc is necessary to synthesize protein that helps the pressure ulcer to heal.

Calories

• Enough calories must be consumed in order for protein, vitamins and minerals to have maximal effect, The necessary calories depend on individual condition and pressure ulcer stage. The average person needs 25-35 calories per kilogram body weight. Calorie needs decrease if bedridden. Calorie needs increase with certain diseases and conditions. A dietitian can calculate accurate individual calorie needs. In acute and long-term care setting dietitians typically follow every patient regularly.

Supplements

• High calorie protein shakes are available to help people with extra nutrient needs. These drinks are especially helpful in people with poor appetites. Protein shakes can be used 1 to 3 times per day depending on the individual's needs. Protein powder can to help increase protein intake. Protein powder can be mixed with yogurt, smoothies or soup, and is usually tasteless.