Protein-Based Nutrition for Chronic Wounds: A Clinician's Guide to Patient Selection, Dosing, Monitoring, and...

Area of Science:

• Wound healing and regenerative medicine
• Nutritional science and metabolism
• Clinical research methodology

Background:

• Chronic wounds are a significant global health issue, often failing to heal due to inflammation, oxidative stress, and impaired matrix remodeling.
• Nutritional interventions, particularly protein optimization and supplementation with arginine, glutamine, and β-hydroxy-β-methylbutyrate (HMB), show promise in improving wound healing.
• Evidence suggests benefits in pressure injuries, diabetic foot ulcers, and venous ulcers when combined with standard care.

Purpose of the Study:

• To review and translate current evidence on protein-based nutrition for chronic wound management.
• To provide a clinician-oriented framework for patient selection, prescribing, monitoring, and treatment adjustment.
• To identify gaps in evidence and suggest future research directions.

Main Methods:

• Systematic review and interpretation of existing clinical evidence on nutritional interventions for chronic wounds.
• Attention to study design and reporting standards (e.g., CONSORT, STROBE, STARD).
• Framework development based on evidence synthesis for practical clinical application.

Main Results:

• Protein-based nutrition, with optimized intake (1.25-1.5 g/kg/day) and specific functional components, can improve wound healing outcomes.
• Evidence is heterogeneous across wound types, necessitating careful consideration of dosing, duration, and patient selection.
• Safety monitoring is essential, particularly for patients with renal or diabetes-related risks.

Conclusions:

• Protein-based nutrition is a valuable adjunct, not a replacement, for standard chronic wound care.
• A structured approach to patient selection, initiation, and monitoring is recommended for stalled wounds.
• Future research should focus on pragmatic trials, personalized approaches, and biomarker-informed strategies.