By Mary Ellen Posthauer RDN, CD, LD, FAND
During the wound healing process, aggressive nutritional support can reverse the body's hypermetabolic state, which occurs when lean body mass is used for energy rather than tissue repair. When energy stores are rapidly depleted in a healthy adult, this can lead to acute malnutrition. In the already compromised individual, however, it can lead to severe protein-calorie malnutrition. Malnutrition increases the risk of morbidity and mortality, and decreases function and quality of life. When the return to the previous quality of life is anticipated, individuals with continued compromised intake along with the burden of increased nutrient needs from stress and chronic wounds may benefit from enteral nutrition (tube feeding). Parenteral nutrition should be used only when the GI tract is not functional, cannot be accessed, or when the individual cannot be adequately nourished by enteral nutrition.