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Nutrition and Wound Healing: Practical Takeaways for Wound Care Practitioners


April 24, 2025
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A typical approach to wound healing often includes topical treatments, antimicrobial dressings, or skin substitutes, but these interventions only reach their full potential when paired with optimal nutrition. In a session presented at WoundCon Spring 2025, Nancy Munoz, DCN, MHA, RDN, FAND, and Mary Litchford, PhD, RDN, LDN, discussed the crucial role of proper nutrition in wound healing. “Without the right nutrients,” remarked Dr. Munoz, “the body cannot go through the necessary stages of healing as it should, which can slow down recovery.”

The body’s ability to regenerate tissue, fight infection, and restore skin integrity is heavily dependent on its nutritional state. The speakers stressed that suboptimal nutrition compromises immune function, slows collagen synthesis, and weakens new tissue, leaving patients vulnerable to complications and prolonged healing.

Macronutrients—carbohydrates, fats, and proteins—are central to the body’s wound-healing processes. Carbohydrates, while often overlooked in clinical discussions, are vital as the body’s primary energy source, Dr. Munoz shared. They support cellular activities, fuel the inflammatory response, and protect protein from being diverted as an energy substitute. The speakers noted that emphasis should be on quality; high-fiber, complex carbohydrates like whole grains, legumes, fruits, and vegetables provide both energy and essential nutrients. In contrast, excessive consumption of low-quality, sugar-laden carbohydrates like sodas and pastries can impair healing and exacerbate chronic diseases. 

Fats also play a critical role, particularly unsaturated fats found in sources like olive oil, nuts, and seeds, noted Dr. Munoz. These fats maintain cellular integrity and reduce inflammation, she said, while saturated fats and trans fats, common in processed foods, contribute to systemic inflammation and should be minimized. 

Protein, however, remains the nutrient most directly associated with tissue regeneration and immune defense. For wound healing, Dr. Munoz noted that patients often require 1.25 to 1.5 grams of protein per kilogram of body weight, and even up to 2.0 grams/kg in cases of severe wounds or critical illness. Both animal-based complete proteins and thoughtfully combined plant-based sources can fulfill these needs.

Among amino acids—the molecules that form protein—arginine is especially noteworthy. Though the body can normally synthesize arginine, the added stress of a wound significantly increases the demand, making it a conditionally essential nutrient, supporting nitric oxide production and collagen formation. Dr. Munoz emphasized that supplementation only proves beneficial if overall protein intake is adequate, however. 

Micronutrients are equally indispensable. Dr. Munoz particularly noted that Vitamins A and C support collagen synthesis, immune function, and epithelialization, while deficiencies can lead to fragile capillaries, reduced wound strength, and higher infection risk. Zinc is critical for DNA replication and inflammatory responses but should only be supplemented for short periods, as long-term use may lead to copper deficiency anemia. Iron, too, is vital for oxygen transport and collagen integrity.

Hydration is another cornerstone of wound healing. The general guideline of 1 mL of fluid per calorie consumed, Dr. Munoz said, helps ensure adequate perfusion and nutrient transport. Dehydration not only suppresses appetite but also slows tissue repair. Fluids should come primarily from water, herbal teas, or milk, while sugary drinks should be avoided, as they may lead to blood sugar spikes, and patients with renal concerns may need to avoid electrolyte-rich drinks.

Turning the focus to further patient-specific considerations, Dr. Litchford explained how obesity, particularly when accompanied by diabetes, creates an environment of chronic low-grade inflammation and insulin resistance that impairs nutrient delivery to wounds. This state may weaken the immune response and prolongs the inflammatory phase of healing, she explained. Moreover, many individuals with obesity also experience sarcopenia—a loss of muscle mass—which directly impacts the body’s ability to use protein for tissue repair. Weight loss medications like GLP-1 agonists, while effective in reducing appetite, can exacerbate this problem by suppressing overall nutrient intake and causing muscle loss. Dr. Litchford emphasized that a weight loss rate of no more than 1.5 pounds per week is ideal for avoiding excess loss of lean muscle mass. Monitoring these patients for protein sufficiency and micronutrient status is vital.

Ultimately, nutrition interventions should be individualized, culturally sensitive, and based on validated screening tools like the Mini Nutritional Assessment (MNA) or Malnutrition Universal Screening Tool (MUST). Dr. Litchford stressed that relying on albumin or prealbumin as markers of nutritional status is outdated; these reflect inflammatory status, not nutrient sufficiency. Instead, consistent reassessment, collaboration with registered dietitian nutritionists, and attention to patient preferences are essential.

Dr. Litchford noted that “every bite counts towards wound healing.” While there may be many dos and don’ts in the world of nutrition, she advises against making negative comments about foods or nutritional supplements, adding, “Encourage them to eat, because that nutrition makes a big difference in wound healing, and it can make a difference between whether a wound will heal or be stalled for an extended period of time, or possibly never heal.” 

Nutrition is not an accessory to wound care—it is a central pillar of healing. Addressing it systematically, thoughtfully, and holistically can transform outcomes for patients with chronic and acute wounds.

The views and opinions expressed in this content are solely those of the contributor, and do not represent the views of WoundSource, HMP Global, its affiliates, or subsidiary companies.