Pressure ulcers, also known as pressure injuries or bedsores, are wounds that are painful to live with and difficult to treat. With more than 2.5 million cases diagnosed each year, effective and quick relief is critical. So, it’s important to know - how does nutrition affect pressure ulcers?
A broadening body of research suggests that nutrition is the key to pressure ulcer treatment and prevention. The topic of nutrition and pressure ulcers is being studied around the globe, and more and more studies show that nutrition affects pressure ulcers more than we initially believed.
So how does nutrition affect pressure ulcers, and is there a special diet people should follow to prevent or treat bedsores? Let’s dive into the connection between nutrition and pressure ulcers before we give you our top nutritional tips for staying pressure-ulcer free.
How does nutrition affect pressure ulcers and patient outcomes?
How does nutrition affect pressure ulcers? To answer that, let’s take a look at what a pressure ulcer is, and what causes them.
Pressure ulcers can come on in as little as an hour, but take weeks or months to heal. They can develop at home, but many cases are hospital-acquired pressure injuries. Regardless of where a pressure ulcer develops, there are a number of factors at play.
The root cause of any pressure ulcer is, of course, pressure.
In some cases, this means a large amount of pressure applied over a short period of time. In others, this means a small amount of pressure applied over a very long time - such as being bedridden in one position.
The pressure leads to the skin cells being deprived of blood, which carries necessary oxygen and nutrients. Without the nutrients, the skin begins to break down - causing an ulcer. People with comorbidities that impact the flow of blood – like diabetes – are at greater risk for pressure ulcers.
Other things that can impact the formation of pressure ulcers include incontinence, heart or kidney conditions, age, and nutrition or hydration issues.
So how does nutrition affect pressure ulcers?
Like the other issues on this list, poor nutrition and hydration weaken skin tissue. This means patients with one or more of these problems develop pressure ulcers more easily, and healing from them is also more difficult.
When creating a plan for how to prevent pressure ulcers, and how to treat them when they occur, there are a variety of dietary changes you can incorporate.
8 ways to prevent pressure ulcers and speed recovery
Like any illness or injury, the biggest thing you can do to prevent and treat pressure ulcers is make sure your body has the nutrition it needs. Here are a few general nutrition tips to follow, as well as some specific steps you can take to ensure your health.
1. Eat a well-balanced diet
First and foremost, patients should have a balanced, varied diet whenever possible.
How does nutrition affect pressure ulcers as part of a regular diet? A well-balanced diet can decrease the need for supplements and increase a patient’s overall quality of life. Besides the excitement of trying different foods, the body tends to absorb nutrients better from food than supplements.
The nutrient-dense foods that are part of a balanced diet allow the body to strengthen skin tissue, decreasing the risk of pressure ulcers. Should ulcers develop anyway, nutrient-dense foods provide the body with what it needs to heal efficiently.
The most recent dietary guidelines for Americans list vegetables of all kinds, whole fruits, whole grains, and proteins as key nutrient-dense foods for people of every age.
2. Stay hydrated
Hydration is also a key player in how nutrition affects pressure ulcers. Dehydration causes skin tissue to lose some of its plumpness. This means a loss of crucial “padding” around the bony areas where pressure ulcers develop.
Dehydration can also weaken the skin and the body at large. When you’re dehydrated, blood cells have a more difficult time transmitting nutrients to various parts of the body. Skin physically dries out as well, causing more friction.
When learning how nutrition affects pressure ulcers, don’t discount the importance of hydration. Many vitamins and nutrients are water-soluble, and dehydration impacts the body’s ability to absorb and effectively use them.
The recommended fluid intake is about 2.7 liters (11 glasses) for women and 3.7 liters (15 glasses) for men.
It’s important to remember that water isn’t the only way a patient can stay hydrated, though. Sugar-free beverages or foods with a high water content also help to keep a patient hydrated.
3. Give your body enough energy
Should a pressure ulcer develop despite your best efforts, the body will need lots of energy to heal the wound. How does nutrition affect pressure ulcers when it comes to this much-needed energy?
Carbohydrates are where your body gets most of its energy, while healthy fats can help with building and repairing cells. Incorporating carbohydrates and fat into your diet can give your body a much-needed boost while healing a wound like a pressure ulcer.
The key thing to remember here is that nutrition and pressure ulcers are closely linked. There are endless ways to get fat and carbohydrates that are unhealthy.
Pressure ulcer treatment should steer clear of refined carbs and trans fats. Instead, opt for whole grains, fruits and vegetables, and healthy fats from nuts and seeds.
4. Increase your vitamin E levels
Vitamin E is a fat-soluble vitamin with an important role to play in ulcer treatment and recovery. Vitamin E’s main job is to collect “free radicals,” that is, loose electrons in the body and at the site of a wound.
These free radicals can cause excess inflammation and damage lipids and proteins. Vitamin E “scavenges” for free radicals throughout the body and binds to them, so they can’t cause further harm.
In pressure ulcers specifically, a vitamin E gel can cut recovery time in half. This is another of the many ways nutrition affects pressure ulcer recovery. Patients who aren’t getting enough vitamin E in their diet can use a supplement, or eat foods high in vitamin E, like seeds and nuts.
5. Get enough Vitamin C
Vitamin C is commonly known to help with illness, but its effects on pressure ulcers can be very pronounced. Vitamin C increases the absorption of iron, which carries much-needed oxygen throughout the body.
How does nutrition affect pressure ulcers in relation to vitamin C deficiency? One of the things that cause pressure ulcers is a lack of oxygen reaching the tissue. Vitamin C helps minimize that problem by promoting iron absorption.
Vitamin C also promotes white blood cell production, as well as collagen promotion and synthesis. Vitamin C and collagen are a dream team when it comes to preventing and healing pressure ulcers.
Patients can increase their intake of vitamin C through foods like citrus fruits and cruciferous vegetables – such as broccoli, cauliflower, cabbage, and brussels sprouts.
6. Boost your vitamin A intake
Vitamin A helps to boost a patient's immune system. Essentially, vitamin A sounds louder “alarm bells”, increasing the rate at which your body heals itself and fights infection. Slow wound healing is even a symptom of vitamin A deficiency!
Vitamin A nutrition affects pressure ulcers by ensuring the body is working at its best to heal these wounds. Increasing a patient’s intake of vitamin A can be done with supplements or through leafy greens and orange and yellow fruits and veggies.
7. Make sure you’re getting enough zinc
Zinc is one of the building blocks the body uses in creating collagen and other proteins. This mineral is absolutely essential for cell creation and growth.
How does nutrition affect pressure ulcers in relation to zinc? A deficiency in zinc can cause a lack of appetite, which may contribute to malnutrition in patients. That malnutrition, as we’ve seen, causes wounds to develop quicker and heal slower.
Foods high in zinc include meat and shellfish, as well as seeds and legumes – like chickpeas or beans. Patients may also need a supplement when dealing with severe zinc deficiency.
8. Take protein and collagen for pressure ulcers
Getting enough protein is the most essential thing you can do to treat and prevent pressure ulcers. Protein is the cornerstone of every cell in your body, and when it comes to skin tissue, collagen is the protein your body needs most.
The body specifically needs collagen due to its role in forming and strengthening skin, connective tissue, and muscles. Adding collagen to your diet is one of the clearest ways nutrition affects pressure ulcers.
You can find some collagen in natural sources, such as fish, chicken, and egg whites. You can also use supplemental collagen for pressure ulcers – ideally one with hydrolyzed protein to help the body process the collagen protein effectively.
In recent studies, collagen-rich protein supplements were shown to decrease formation of pressure ulcers by as much as 25% - and help them heal twice as quickly.
These are just two instances from a growing body of research on collagen for pressure ulcers. Across the board, they’re finding that collagen supplements can make a huge difference in pressure ulcer prevention and recovery.
BONUS: beyond nutrition for pressure ulcers
Now that you know how nutrition does affect pressure ulcers, it’s important to remember that nutrition isn’t the end-all and be-all for health. When creating a treatment plan, it’s important to couple targeted nutrition with exercise and medical guidance.
Make time for movement
We’ve already discussed how nutrition affects pressure ulcers through a healthy diet. Now, onto the “exercise” portion.
Movement has long been a part of prevention and treatment for pressure ulcers. A nurse’s role in pressure ulcer prevention places heavy emphasis on movement – such as helping to turn patients and moving their limbs when they’re unable to do so.
The highest-risk for pressure ulcers typically occurs in cases where a patient has mobility issues. These are also the cases where movement of any kind becomes all the more critical. Turning or adjusting a patient can significantly decrease the risk for pressure ulcers, especially when paired with a healthy diet.
Movement takes pressure off any one part of the body, preventing pressure ulcers.
In cases where the patient is relatively healthy, but has a condition that makes them a higher risk for pressure ulcers, swimming may be part of their movement plan. Swimming can take pressure off of high-risk areas, like the heels.
Get screened for risk
When developing a treatment and prevention plan for pressure ulcers, screening is critical. Screening can include diagnostic tools and/or practitioner assessment. The extra time and energy that this takes are well worth it.
The cost of hospital-acquired pressure ulcers for the US healthcare system is around $11.6 billion annually. For patients, pressure ulcer prevention can add to already painful conditions, as well as damage their trust in caregivers.
When patients are screened, providers get information that can make the difference between a patient with a pressure ulcer and a patient who is ulcer-free. In this patient, how does nutrition affect pressure ulcers? Are they malnourished or dehydrated? Are they capable of movement? How much?
It’s much easier to provide information on how nutrition affects pressure ulcers and help the patient improve movement before an ulcer develops, and the answers to these questions can help caregivers put together a customized prevention plan.
Nutrition and pressure ulcers: finding the right plan for you
When creating a plan for how to prevent bed sores, nutrition is key. How does nutrition affect pressure ulcers? The simple answer is that good nutrition helps at every stage of wound healing (even prevention).
Everyone’s body is different. High-protein diets are great for all people, but the specific plan you need will vary, so it’s important to work with all members of your care team. They can help to check for deficiencies and help you find a plan that works for you.
In pressure ulcer treatment, nutrition can boost the body’s immune system and help strengthen the skin and muscles. Collagen products can add elasticity to the skin during the preventative stage, decreasing the risk of developing a pressure ulcer.
If an ulcer has already occurred, collagen and a nutrient-rich diet can speed recovery time by ensuring the body has what it needs to heal. Nutrition affects pressure ulcers in the same way it affects healing from any other illness or injury.
Food is fuel, and making sure the body has the right fuel can make pressure ulcer prevention and recovery run that much more smoothly.