Nutrition and ulcer and wound healing

Patients with a wound should be screened for malnutrition as part of their clinical review. Malnutrition is common in people with chronic wounds, and is often not recognised. If identified, malnutrition should be treated, despite limited evidence that this is beneficial for wound healing.

Protein and energy requirements are higher for patients with chronic wounds. Ensure patients are meeting their intake requirements—protein and calorie supplements may be required, consider referral to a dietitian. Even patients with a high body mass index (BMI) can be malnourished. At the time of writing, there is no evidence to support enteral nutrition (eg percutaneous endoscopic gastrostomy [PEG] or nasogastric feeding) for wound healing. Any identified micronutrient deficiency should be treated; however, there is little evidence that nutritional therapy (including routine vitamin C or zinc supplements in patients without deficiency) is of benefit.

There is increasing evidence that supplements containing arginine promote healing of stage II to IV pressure injuries, but they do not have proven efficacy for other wounds.

General dietary advice is provided in the Australian Dietary Guidelines, available here.