Pressure ulcer and nutrition

IntroductIonThe main aim of the present article is to review the current evidence related to hydration and nutrition for bedsore prevention and management in adults announced by the nutrition endorsements from the last National Pressure Ulcer Advisory Panel (NPUAP) and European Pressure Ulcer Advisory Panel guidelines for pressure ulcer treatment. [1]ydration and nutrition have an essential role in skin and tissue viability and help tissue repair in management of pressure ulcer.This article is concerned with the association between nutrition and prevention and cure of pressure ulcers. [2]Mechanisms by which nutritional support helps prevent bedsore are not defined, but at least, it is well known that the nutritional status should be well promoted. prevalence, IncIdence, and health-care burden of pressure ulcersIn the USA, approximately 1-3 million people develop pressure ulcers each year, [3] and more than 2.5 million patients in the United States acute care services suffer from pressure ulcers, and 60,000 each year die from the complications of such ulcers. [4]In the United States between 1990 and 2000, the NPUAP reported a prevalence rate of pressure ulcer ranging from 10% to 18% in general acute care, 2.3% to 28% in long-term care and up to 29% in home care, and 0% to 6% in rehabilitative care. [5,6]Pressure ulcers can diminish global life quality because of pain, management procedures, and increased length of hospital stay.Furthermore, they contribute to rapid mortality in some patients. [7]Therefore, any intervention that may assist to avoid pressure ulcers or to treat them may be important to decrease the cost of pressure ulcer care and increase life quality of affected individuals. [1]Pressure ulcer management costs are a major problem to healthcare organizations.In the UK, the cost is estimated at £1.4-£2.1 billion annually [8] and in the US is Pressure ulcers can diminish global life quality, contribute to rapid mortality in some patients and pose a significant cost to health-care organizations.Accordingly, their prevention and management are highly important.Nutritional deprivation and insufficient dietary intake are the key risk factors for the development of pressure ulcers and impaired wound healing.Unplanned weight loss is a major risk factor for malnutrition and pressure ulcer development.Suboptimal nutrition interferes with the function of the immune system, collagen synthesis, and tensile strength.No laboratory test can exactly define an individual's nutritional status.Although serum albumin, prealbumin, transferrin, and retinol-binding protein as well as anthropometric measures such as height, weight, and body mass index and the other laboratory values may be suitable to establish the overall prognosis, still they might not well represent the nutritional status.Although the ideal nutrient intake to encourage wound healing is unknown, increased needs for energy, protein, zinc, and Vitamins A, C, and E and also amino acids such as arginine and glutamine have been documented.Hydration plays a vital role in the preservation and repair of skin integrity.Dehydration disturbs cell metabolism and wound healing.Adequate fluid intake is necessary to support the blood flow to wounded tissues and to prevent additional breakdown of the skin.The main aim of the present article is to review the current evidence related to hydration and nutrition for bedsore prevention and management in adults.