Mary Ellen Posthauer's blog

By Mary Ellen Posthauer, RDN, CD, LD, FAND

The World Union Wound Healing Society (WUWHS) held their 2016 meeting in historic Florence, Italy in September. The initial meeting of the WUWHS was held in Australia in 2000 and is convened every four years. I have had the unique opportunity to present in Paris, Toronto, Yokohama and this year in Florence on the topic of nutrition and wound healing. 4,226 clinicians attended the conference including 525 from the US. The convention center was a modern venue surrounded by the ancient walls of the Roman fortress.

By Mary Ellen Posthauer RDN, CD, LD, FAND

The National Pressure Ulcer Advisory Panel (NPUAP) has designated November 17, 2016 as World Wide Pressure Injury Prevention Day and is urging states to join the effort and raise awareness about the need to prevent pressure injuries. As of October 1st, North Carolina, New Jersey, Nevada, and the District of Columbia have issued State Proclamations for Pressure Injury Prevention Awareness Day. The NPUAP is working through Congressional channels to seek a Federal Declaration from the President for a Pressure Injury Prevention Awareness Day to occur each year on the 3rd Thursday of November. This would then coincide with their worldwide partners.

By Mary Ellen Posthauer RDN, CD, LD, FAND

Medical Nutrition Therapy (MNT) should be an integral part of your pressure Injury (ulcer) management plan. Malnutrition/undernutrition is a risk factor for pressure injury formation and prolongs the healing process. Since nutrition is one component of both the treatment and prevention plan (along with dressings, treatments and support surfaces), having a written MNT protocol assists the interdisciplinary team in achieving a positive outcome for the individual/patient. The collaborative, interdisciplinary approach should include the individual and their family/caregiver.

By Mary Ellen Posthauer RDN, CD, LD, FAND

Clinicians continue to question if oral or tube feedings formulated with arginine hasten wound healing time versus standard high calorie, high protein supplements. There is an increase in the number of studies that examine the role of arginine in combination with other nutrients to facilitate pressure injury healing. Many of the studies were conducted in Europe or Australia using products that are not always marketed in the United States. However, very similar products are available.

By Mary Ellen Posthauer RDN, CD, LD, FAND

The April National Pressure Ulcer Advisory Panel (NPUAP) consensus conference resulted in a terminology change from pressure ulcer to pressure injury, and also validated new terminology which more accurately describes pressure injury in intact and ulcerated skin. The previous staging system described both Stage 1 and Deep Tissue Injury as injured intact skin and the other stages described open ulcers. There has been confusion because the definitions for each of the stages referred to the injuries as "pressure ulcers". The term "suspected" was removed form the Deep Tissue Injury diagnostic label and Arabic numbers are now used instead of roman numerals.

By Mary Ellen Posthauer RDN, CD, LD, FAND

The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT) amends Title XVIII of the Social Security Act by adding a new section –Standardized Post-Acute Care (PAC) Assessment Data for Quality, Payment, and Discharge Planning. The goal of the IMPACT Act is to reform PAC payments and reimbursement while ensuring continued beneficiary access to the most appropriate setting of care. The act requires the submission of standardized and interoperable PAC assessment and quality measurement data by Long-Term Care Hospitals (LTCH), Skilled Nursing Facilities (SNF), Home Health Agencies (HHA) and Inpatient Rehabilitation Facilities (IRF).

By Mary Ellen Posthauer RDN, CD, LD, FAND

Several nutrients, such as arginine, zinc, vitamin A, vitamin E and vitamin C, play a key role in wound healing and preserving tissue viability. However, while current research doesn’t confirm consuming mega doses of any of these minerals or vitamins, there are studies supporting combining adequate amounts of these nutrients in an oral nutritional supplement to facilitate wound healing.

By Mary Ellen Posthauer RDN, CD, LD, FAND

Recently, I attended a webinar that focused on dietary protein and preserving lean muscle mass. There is a wealth of research on this topic, in particular, as it relates to older adults and protecting muscle health during inactivity. Dr. Robert Demling noted the effect of lean body mass (LBM) loss on wound healing. Healing a wound requires increased calories to prevent the body from breaking down protein (LBM) for energy, thus depleting protein stores required for protein synthesis and healing. Lean body mass is metabolically active, transports protein throughout the body and is essential for survival as it contains all of the skeletal and smooth muscles and immune cells. Healthy adults lose between 3-8% of LBM per decade and after age 70 muscle loss increases to 15% per decade. This loss of LBM or sarcopenia is an age-related, insidious loss of lean muscle mass accelerated by physical inactivity and poor nutrition.

By Mary Ellen Posthauer RDN, CD, LD, FAND

The Academy of Nutrition and Dietetics annually designates March as National Nutrition Month and the theme this year is Savor the Flavor of Eating Right. My blog usually focuses on what we as caregivers can do to improve the nutrition of our clients/patients with wounds. However, how often do you as a busy wound care clinician think about your nutrition or what you are eating or probably not eating?

By Mary Ellen Posthauer RDN, CD, LD, FAND

February is American Heart Month and Valentine’s Day is celebrated around the world on the 14th. So what is the connection between protecting your heart, enjoying candy and flowers with those you love on Valentine’s Day, and wound care? Many of your clients with wounds also have some type of heart disease or have elevated lipid levels. These clients need nutritional strategies for wound healing that also protects their hearts.