Nutritional Management

Ryan Cummings's picture

By Ryan Cummings, FNP, CWS

Appropriately balanced nutrition is a cornerstone of high-quality wound care, and this isn’t a new revelation. Nearly all modern wound centers include some version of nutritional screening, along with ever-expanding recommendations regarding overall protein intake, complex carbohydrate needs, and micronutrient supplementation as clinical evidence for these is presented.

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By Catherine D’Andrea, RDN, LDN, and Marcia Nusgart, RPh

Malnutrition is a leading cause of morbidity and mortality, especially among older hospitalized adults, yet it often goes undiagnosed and therefore untreated. It has been established that malnourished hospitalized patients experience slower wound healing, higher risks of infection, and longer length of stay. Malnutrition is a burdensome condition associated with a 34% higher cost for a hospital stay compared with a non-malnourished patient. Sufficient macronutrients (carbohydrates, protein, fats, and water) and micronutrients (vitamins and minerals) are vital for the body to support tissue integrity and prevent breakdown. Research supports that weight loss and difficulties with eating can increase the incidence of pressure injuries.

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Lauren Lazarevski's picture

By Lauren Lazarevski, RN, BSN, CWOCN

Could metallic micronutrients be the missing link for your patient with a chronic wound? When we consider the nutrition required to optimize wound healing, protein supplementation is usually the star of the show. However, there are micronutrients involved in wound healing on a cellular level. Although the daily requirements may be small, they are mighty—and if deficient, they may be the missing step in healing a chronic wound.

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Cathy Wogamon's picture
Pilonidal Cyst

By Cathy Wogamon, DNP, MSN, FNP-BC, CWON, CFCN

A pilonidal cyst is a pocket located at the top of the cleft of the buttocks that usually results from an embedded or stiff hair. This area may remain dormant for years and cause no major issues; however, often the embedded or stiff hair may cause the cyst to become inflamed and infected, resulting in an abscess that requires an incision to drain the infected material. These abscesses can recur, causing the patient to require surgical intervention to remove the cyst. After surgery, some patients tend not to heal well, and the result is a chronic, tracking wound in an area that is difficult to heal.

WoundSource Practice Accelerator's picture

Delayed wound healing occurs in various wound types and in patients with significant comorbidities. Hard-to-heal wounds have proven to be a challenging and worldwide crisis resulting in high financial burdens.

Heidi Cross's picture
Nutrition Management

By Heidi Cross, MSN, RN, FNP-BC, CWON

"Defendants failed to provide adequate nutrition to prevent plaintiff from suffering severe malnutrition and weight loss. This allowed the development of a severe pressure ulcer, numerous infections, and dehydration and malnutrition. Had defendants provided proper care, the pressure ulcer, infections, and malnutrition and dehydration would not have occurred."

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Heidi Cross's picture

By Heidi Cross, MSN, RN, FNP-BC, CWON

In the previous blog, I briefly went through the standards of care when it comes to nutrition and pressure injury (PI) prevention and development and discussed what a large role nutrition plays in PI litigation. Here are several instances: Punitive damages of $92 million, later lowered to $11,855,000, were imposed where malnutrition and dehydration were proven against a nursing home. A dietary manager for a nursing home told state surveyors that her nursing home had "dropped the ball" on a resident's nutrition needs when that resident had lost 17 pounds in 75 days; a $1,385,000 settlement was reached. Malnutrition with a loss of 27% of body weight in 15 months led to a $380,000 settlement just before trial. Shocking, isn't it? It literally "pays" to pay attention to nutrition standards of care.

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By the WoundSource Editors

Venous ulcers are known to be complex and costly. There is an array of evidence-based treatment options available to help formulate a comprehensive treatment plan toward wound closure. Health care professionals should utilize treatment options while encompassing a holistic approach to venous ulcer management. Involving the patient and/or caregiver in developing a treatment plan will increase the chances of successful wound healing outcomes. Wound closure is the primary goal of a treatment plan; however, preventing recurrence and infection should be considered just as important.

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Emily Greenstein's picture
Wound Care Resolutions

By Emily Greenstein, APRN, CNP, CWON, FACCWS

The New Year is finally here, the beginning of a new decade. And we all know that with the calendar change comes the urge to get rid of any and all bad habits. Time to start over, wipe the slate clean, and transform into something amazing. Except, in reality it never seems to happen that way. We may start out well and then fall off the wagon and back into old habits.

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Fabiola Jimenez's picture
Nutrition Management

Fabiola Jimenez, RN, ACNS-BC, CWOCN

While I was providing foot care to a patient, one of my coworkers overheard me advising the patient that she will need a lot more protein to heal her wound, and some changes to her diet will be necessary and therefore tighter control of her blood glucose and improved hemoglobin A1c. Later, I was approached by a coworker who told me: "Because you are not a Registered Dietitian, you cannot discuss dietary needs with the patient." I disagree.

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