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Nutrition and Wound Healing: Eat Well, Live Well.

In this issue ofAdvances, three articles explore important nutrition topics and their relationships to wound healing. Their findings As we all know, obesity is a major nutrition-related concern for wound care patients. Obesity is often associated with the three emphasize that all of our patients—and even ourselves, as providers—can use good nutrition to support skin health and prevent injury. The first article is a secondary analysis of a randomized controlled trial examining the influence of nutrition on pressure injury outcomes among Asian nursing home residents. Dr Yap and her coinvestigators noted that Asian residents were more likely to develop pressure injuries; 6 of 97 Asian participants (6.19%) developed pressure injuries, but only 4 in the 408 (0.98%) non-Asian residents did. The risk factors for the increased incidence among Asian residents included a marginally lower body mass index, smaller meals, and a higher incidence of tub baths that may have compromised skin integrity. As part of their nutrition documentation, the authors examined five factors: the percentage of the meals consumed, number of servings, types of protein, liquid protein supplements, and snacks. A very interesting observation was that Asian participants had a higher protein intake from meat sources and less from liquid protein supplements. The authors note that this may be because most liquid protein supplements have a lactose base. They quoted a 99% incidence of lactose deficiency in Asians with only a 32% rate in non-Asians. These findings remind us that the detailed evaluation of nutrition is complex. Ifmeat is not fully digested, it may offer less protein to the body. Lactose-deficient individuals ingesting a lactose protein combination supplement will experience cramps, bloating, and loose stools. There is obviously a need to develop alternative liquid protein delivery carriers. Future research should examine other populations or additional high-risk variables with a more detailed dietary assessment. Also included in this issue, an excellent systematic review by Kara Schneider and Najat Yahia, Effectiveness of Arginine Supplementation on Wound Healing in Older Adults in Acute and Chronic Settings, identified 39 RCTs and ultimately examined six articles that met the inclusion criteria. Arginine is an amino acid that is an essential building block of proteins. In addition, arginine has several other important functions as outlined in the article. The authors recommend arginine supplementation (as low as 4.5 g) in conjunction with oral nutrition supplementation because it may promote wound healing in older adult patients in acute and long-term care settings. However, the reviewed literature did not support the use of arginine supplementation alone to promote wound healing. Check the evidence in this article: will you routinely recommend or use arginine supplements?