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Patient Education - Nutrition for wound healing in action - Step 2: Leverage supplements

Patient Education - Nutrition for wound healing in action - Step 2: Leverage supplements

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Patient Education - Nutrition for wound healing in action - Step 2: Leverage supplements

What is oral nutritional supplementation?

In addition to the balanced meals suggested in the topic "Patient Education - Nutrition for wound healing in action - Step 1: Map out your meals", oral supplementation may be recommended by your healthcare professional. Oral Nutritional Supplementation (ONS) is a way to provide your body with additional macro and micronutrients that may be lacking in your diet. They are widely used in the treatment of acute injuries for individuals who are unable to meet their nutritional needs from food alone.[1] 

Oral supplementation may not be necessary for everyone but can help boost levels of nutrients that you may be missing from your diet. For example, over 40% of the US population is deficient in vitamin B12, and supplementation is the recommended course of action. When your body is healing a wound, what you eat can directly speed up the healing process.[2] 

Common oral nutritional supplements for wound healing are listed in Table 1 below. Talk to your healthcare provider to see if you would benefit from oral nutritional supplements and which ones are recommended for you.


Table 1. Common oral nutritional supplements for wound healing

Supplemented NutrientThe BasicsThe Details
Proteins
  • As previously mentioned, protein is one of the most important macronutrients when healing a wound. Proteins are responsible for the formation of your skin and muscles, as well as the shrinking of the wound.[3]
  • Protein supplements come in different formats, such as protein shakes, puddings, bars, powders, etc.
    • Arginine is an amino acid, one of the building blocks of proteins; it decreases wound size and exudate, and supports rapid wound closure.[3][4]
    • Generally, 1 gram of protein per kilogram of body weight is a good baseline. For those with stage I-III pressure ulcers/wounds, 1.3-1.5 g/kg is recommended. For stage IV ulcers/wounds, 1.5-2 g/kg is recommended. To give you an idea of size, one ounce (oz) equals 28.35 grams; three ounces (85 grams) is a portion that is about the size of your palm. For instance, a slice of meat equals 85 grams
    Vitamin A
    •  Vitamin A is required for the body to defend itself from harmful microbes and also helps heal wounds. Lack of vitamin A can slow down wound healing; without vitamin A your body may have trouble creating collagen, a protein that is essential for wound closure.
    • For stage I and II pressure ulcers, 10,000-25,000 IU every 10 days are recommended (this can be in the form of a pill). For stage III and IV pressure ulcers, 5,000 IU for every 1,000 calories is recommended.[3]
    Vitamin C
    • Vitamin C assists in the formation of collagen, the most important protein of connective tissue.


    • For stage I and II pressure ulcers, 250mg/day is recommended. For stages III and IV pressure ulcers, 1,000mg/day is recommended.[3]
    Zinc
    • Zinc is not a vitamin but rather a mineral. It is important in the healing of wounds. Lack of zinc in your body can lead to less collagen formation, decrease your body’s ability to defend itself from harmful microbes, and slow down the creation of healthy skin tissue over the wound.
    • Patients with a wound are recommended to take between 25-50mg of zinc per day, and those who show signs of deficiency are advised to supplement 50mg/day for 3 months.[5] 


    How can I get oral nutritional supplements?

    Oral nutritional supplements may be obtained at local pharmacies and online stores. Ask your healthcare providers if oral nutritional supplements are recommended for you. If oral nutritional supplements are indicated, follow your healthcare provider’s recommendations regarding appropriate supplements and suppliers.  

    How do I put what I have learned into action? 

    Glad you asked! Click on the topics below to jump-start good eating habits that will help you heal your wounds faster 

    • Patient Education - Nutrition for Wound Healing : Understanding the Basics
    • Patient Education - Nutrition for wound healing : What if I have other health conditions?
    • Patient Education - Nutrition for wound healing in action - Step 1: Map out your meals
    • Patient Education - Nutrition for wound healing in action - Step 2: Leverage supplements (this topic)
    • Patient Education - Nutrition for wound healing in action - Step 3: Shop smartly
    • Patient Education - Nutrition for wound healing in action - Step 4: What if I don’t cook

    When to contact your healthcare provider

    In general, if there is little to no improvement in the condition of your wound/pressure ulcer, it is a good time to reach out to your healthcare provider. Proper nutrition can pave the way to a clean and healthy wound, as well as improve your overall health and well-being. 



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    NOTE: This is a controlled document. This document is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.

    REFERENCES

    1. Brown SA, Coimbra M, Coberly DM, Chao JJ, Rohrich RJ et al. Oral nutritional supplementation accelerates skin wound healing: a randomized, placebo-controlled, double-arm, crossover study. Plastic and reconstructive surgery. 2004;volume 114(1):237-44.
    2. Hazra A, Kraft P, Selhub J, Giovannucci EL, Thomas G, Hoover RN, Chanock SJ, Hunter DJ et al. Common variants of FUT2 are associated with plasma vitamin B12 levels. Nature genetics. 2008;volume 40(10):1160-2.
    3. Quain AM, Khardori NM et al. Nutrition in Wound Care Management: A Comprehensive Overview. Wounds : a compendium of clinical research and practice. 2015;volume 27(12):327-35.
    4. Schneider KL, Yahia N et al. Effectiveness of Arginine Supplementation on Wound Healing in Older Adults in Acute and Chronic Settings: A Systematic Review. Advances in skin & wound care. 2019;volume 32(10):457-462.
    5. Kogan S, Sood A, Garnick MS et al. Zinc and Wound Healing: A Review of Zinc Physiology and Clinical Applications. Wounds : a compendium of clinical research and practice. 2017;volume 29(4):102-106.
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