Nutritional intake and status of clients in the home with open surgical wounds

The purpose of this study was to determine (a) whether the nutritional intake of patients at home with wounds healing by secondary intention was adequate to support healing, and (b) the nutritional status of these patients. Nineteen subjects with a mean age of 65.3 years were accrued. Of the 17 subjects for whom nutritional intake data were available, 16 had insufficient caloric intake to support healing and over half had less than the Recommended Daily Allowance (RDA) of protein. Using the RDA as a conservative measure of vitamin and mineral need with injury, Vitamin C intake was decreased in approximately one third of the subjects, while all but one had decreased zinc intake. Over two thirds of the subjects reported a decrease from their usual weight and all the subjects measured had triceps skin fold (TSF) and mid-arm muscle circumference (MAMC) which were below the first and second Health and Nutrition Examination Surveys (HANES I & II) median. Mean serum albumin of the sample was below normal. The nutritional intake of these patients needs increased attention. Community health nurses (CHNs) need to assess nutritional status and monitor the intake of patients with wounds. Future research needs to address why intake is decreased and test strategies to increase oral intake.