Dietary intake in clients with chronic wounds

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.