Protein is a very important nutrient for building muscle. It provides the building blocks for cellular growth and repair, like those found in muscle, skin, and nails. It is also used to make enzymes and hormones. Protein is basically the structural and functional component of our body! Without boring you with the details, it is needless to say that protein is very important!

It can also help us recover faster from surgery, injury, and illness. Your proteins needs are slightly higher than normal when injured or sick. Try to aim for g of protein at each meal at least 3 times a day.

What does this look like though? Here are examples of the protein content in several common foods:. While some foods provide more protein than others, they can be combined to give you the amount that you need. We usually do not need these types of products and should focus on meeting our protein needs from foods itself.

Our body can only handle so much at a time! When suffering from an injury or recovering from surgery, you will need a bit extra. When we are injured or recovering from surgery we likely have quite a bit of inflammation near the injured site. Some foods and nutrients can help reduce inflammation!

Some of these foods include:. Again, it is best to focus on eating nutrient dense foods instead of relying on supplements. Large doses of anything, even vitamins and minerals, can be damaging to our body and organs. Discuss taking any supplements with your doctor or a Registered Dietitian first.

In the study by Wong et al. the determination of viable tissue was based on examination of the site and the retrospective analysis of photographs of sores, which may have led to bias in data interpretation. Both the time period and the survey size were small.

When hospital discharge occurred, control of the use of the mixture intervention was via the verbal reports of the relatives. featured only malnourished patients.

Chart 1 shows the characteristics of the studies found. Chart 1 Randomized clinical trials selected, describing authors, location, number of patients, intervention and results found.

The objectives of nutritional therapy in patients with pressure ulcers include the promotion of tissue regeneration and the facilitating of the healing process 20 20 Dalapicola MM. A importância do suporte nutricional em pacientes portadores de úlcera de pressão. Cad Saúde Desenv.

The main nutrients used in the studies were arginine, beta-hydroxy-beta-methylbutyrate, zinc and antioxidants. Other substances were also included in the supplements used, such as glutamine, selenium, copper and vitamin C 14 14 Leigh B, Desneves K, Rafferty J, Pearce L, King S, Woodward MC, et al.

Proteins participate in neovascularization, fibroblast proliferation, collagen synthesis, and leukocyte production and migration 20 20 Dalapicola MM. The main immunonutrients used in enteral formulations for the treatment of pressure lesions are arginine, glutamine and amino acids, which exercise a substrate function in the biochemical pathways responsible for mediating collagen synthesis and immune response.

Arginine is a substrate for ornithine, nitric oxide and proline, which results in vasodilation, synthesis and collagen deposition, as well as being a conditionally essential amino acid, necessary during the active growth phases and in the healing process, diabetes and stress situations.

Glutamine is the most abundant free amino acid in the body. Classified as a non-essential amino acid, its synthesis, in critical situations of metabolic stress, does not meet the demand required by the organism.

Glutamine has been shown to be important in healing as it is related to collagen synthesis and the proliferation of inflammatory cells 3 3 Blanc G, Meier MJ, Stocco JGD, Roehrs H, Crozeta K, Barbosa DA. Nutrition and skin ulcers. Curr Opin Clin Nutr Metab Care.

Arginine-enriched oral nitritional supplementation in the treatment of pressur ulcer: a literature review. Wound Med. Beta-hydroxy-beta-methylbutyrate supplementation is associated with an increase in muscle mass and may inhibit muscle proteolysis and modulate protein turnover.

Zinc, copper and selenium also appear to be beneficial to the healing process. Zinc is a cofactor for the formation of collagen, granulation and epithelial tissue, has an antioxidant function and is important for protein synthesis. Copper participates in the cross-linking reactions of collagen, elastin and the elimination of free radicals 3 3 Blanc G, Meier MJ, Stocco JGD, Roehrs H, Crozeta K, Barbosa DA.

The Role of Nutrition for Pressure Ulcer Management: National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance White Paper.

Selenium is required for the functioning of the glutathione system, responsible for the management of inflammation induced by oxidative stress 24 24 Aguiar AO, Oliveira BBR, Carnib LPA.

Efeito dos antioxidantes vitamina C e selênio em pacientes queimados: uma revisão bibliográfica. Rev Bras Queimaduras. Vitamin C acts on the formation of collagen and the functioning of neutrophils and macrophages in the inflammatory phase. It also acts as a reducing agent, protecting copper and iron from oxidative damage, as well as participating in all the healing stages 23 23 Posthauer ME, Banks M, Dorner B, Schols JMGA.

The majority of participants in the studies were elderly, as illustrated by the advanced average age. Elevated age is considered a risk factor for the development of PU, probably due to changes in the skin and subcutaneous tissue of the elderly during the aging process, making it more fragile and susceptible to pressure, friction and shear forces.

There was a predominance of females, characterizing what literature describes as "the feminization of old age", a phenomenon that also occurs in Brazil 26 26 Santos AA, Mansano-Schlosser TCS, Ceolim MF, Pavarini SCI. Sleep, fragility and cognition: a multicenter study with Brazilian elderly.

Rev Bras Enferm. A systematic review by Pedroni et al. O impacto da desnutrição no desenvolvimento e na gravidade das úlceras por pressão: uma revisão da literatura. Rev Bras Ciênc Envelhec Hum. evaluated the impact of malnutrition on the development and severity of PU and revealed, through eight studies, that the risk of developing pressure ulcers is higher in malnourished patients.

Four studies showed that the severity of malnutrition increases the likelihood of having more severe PU or a greater number of lesions. Nutritional status interferes directly with tissue repair. Malnutrition is related to inadequate wound healing, decreased fibroblast production, neoangiogenesis and collagen synthesis, as well as reduced tissue remodeling capacity 10 10 Sociedade Brasileira de Nutrição Parenteral e Enteral; Associação Brasileira de Nutrologia; Sociedade Brasileira de Clínica Médica.

and Cereda et al. did not evaluate the relationship between healing rate and nutritional status. A recent systematic review on the use of arginine-containing supplements found that such substances resulted in a significant improvement in PU healing in malnourished patients and those with normal nutritional status 29 29 Liu P, Shen WQ, Chen HL.

Efficacy of arginine-enriched enteral formulas for the healing of pressure ulcers: a systematic review. Specific nutritional support accelerates pressure ulcer healing and reduces wound care intensity in non-malnourished patientens.

The authors suggest that a 4. concluded that the use of specialized amino acids does not appear to reduce wound size and PUSH scores, but may improve tissue viability after two weeks. In both studies the follow-up time was short, with three and two weeks respectively. In a previous study performed by Cereda et al.

Disease Specific, Versus Standard, Nutritional Support for the Treatment of Pressure Ulcers in Institutionalized Older Adults: a randomized controlled trial. Am Geriatr Soc. This systematic review presented some limitations, as the sample sizes of the studies included were small, ranging from 23 to subjects.

The studies employed different outcomes, nutritional assessment, proportion of areas and tissue evaluation tools Visitrak, PUSH , and follow-up times, ranging from two to twelve weeks.

The therapeutic benefits of nutrition should be encouraged by multi-professional teams. Nutritional intervention should be considered an integral part of the treatment of pressure ulcers. The evaluation of the nutritional status of patients is recommended, as is ensuring adequate energy and protein intake as recommended by current guidelines.

Several studies have pointed to the presence of certain nutrients that can positively affect the healing process of pressure ulcers. The evidence of supplementation with arginine and other amino acids is generally favorable, but is confused by the addition of other nutrients in available commercial preparations and by the fact that the study periods involved have been relatively short.

The use of nutritional supplements enriched with arginine, zinc and antioxidants effectively aided the healing of PU in malnourished patients, although they may have a different effect on patients with adequate nutritional status. More scientifically rigorous studies with standardized interventions and more participants are needed to create an evidence-based nutritional intervention model for the treatment of PU.

Open menu Brazil. Revista Brasileira de Geriatria e Gerontologia. Submission of manuscripts About the journal Editorial Board Instructions to authors Contact.

Português Español. Open menu. table of contents « previous current next ». Abstract Resumo English Resumo Portuguese. Text EN Text English Texto Portuguese. PDF Download PDF English Download PDF Portuguese. Abstract Objective: to review literature on the use of nutritional therapy in the treatment of pressure injuries.

Methods: a systematic review of the PubMed, Lilacs and Scielo databases was performed, with studies in the English and Portuguese languages published in the last five years selected. Result: three articles that investigated the use of different doses of arginine, a mixture of amino acids and nutritional supplements enriched with arginine, zinc and antioxidants were analyzed.

Conclusion: nutritional intervention should be considered an integral part of the treatment of pressure injuries.

Keywords: Pressure Ulcer; Wound Healing; Nutrition Therapy; Diet Therapy. Resumo Objetivo: realizar uma revisão na literatura sobre a terapia nutricional utilizada no tratamento da lesão por pressão. Métodos: revisão sistemática nas bases de dados PubMed, Lilacs e SciELO, selecionando publicações realizadas nos últimos cinco anos, na língua inglesa e portuguesa.

Resultado: foram analisados três artigos que pesquisaram o uso de diferentes doses de arginina, mistura de aminoácidos e suplemento nutricional enriquecido com arginina, zinco e antioxidantes. Conclusão: a intervenção nutricional deve ser considerada parte integrante do tratamento da lesão por pressão.

METHODS A systematic review of literature was conducted in August and September in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA methodology 12 12 Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. RESULTS Following searches in the databases using the previously mentioned descriptors, articles were found, with 98 in PubMed, 16 in Lilacs and 3 in Scielo.

Erratum In the review article "Nutritional therapy in the treatment of pressure injuries: a systematic review", published in the Revista Brasileira de Geriatria e Gerontologia v. Menegon DB, Bercini RR, Santos CT, Lucena AF, Pereira AGS, Scain SF.

Análise das subescalas de Braden como indicativos de risco para úlcera por pressão. Blanc G, Meier MJ, Stocco JGD, Roehrs H, Crozeta K, Barbosa DA. Moraes JT, Borges EL, Lisboa CR, Cordeiro DCO, Rosa EG, Rocha NA. Freitas MC, Medeiros ABF, Guedes MVC, Almeida PC, Galiza FT, Nogueira JM.

Moro JV, Caliri MHL. Bezerra SMG, Luz MHBA, Andrade EMLR, Araújo TME, Teles JBM, Caliri MHL. Sancho A, Albiol R, Mach N. Brito PA, Generoso SV, Correia MIT. Sociedade Brasileira de Nutrição Parenteral e Enteral; Associação Brasileira de Nutrologia; Sociedade Brasileira de Clínica Médica.

Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Higgins JPT, Green S, editors. Leigh B, Desneves K, Rafferty J, Pearce L, King S, Woodward MC, et al.

Wong A, Chew A, Wang CM. Cereda E, Klersy C, Serioli M, Crespi A, D'Andrea F. Dorner B, Posthauer ME, Thomas D; National Pressure Ulcer Advisory Panel. Eberhardt TD, Kessler M, Soares RSA, Lima SBS, Fonseca GGP, Rodrigues LR. Espírito-Santo PF, Almeida SA, Silveira MM, Salomé GM, Ferreira LM.

Dalapicola MM. Neyens JCL, Cereda E, Meijer EP, Lindholm C, Schols JMGA. Posthauer ME, Banks M, Dorner B, Schols JMGA. Aguiar AO, Oliveira BBR, Carnib LPA.

Rogenski NMB, Kurcgant P. Avaliação da concordância na aplicação da Escala de Braden interobservadores. Acta Paul Enferm. Santos AA, Mansano-Schlosser TCS, Ceolim MF, Pavarini SCI. Pedroni L, Bonatto S, Mendes K. Brito PA, Generoso SV, Correia MITD.

Liu P, Shen WQ, Chen HL. Van Anholt RD, Sobotka L, Meijer EP, Heyman H, Groen HW, Topinková E, et al. Cereda E, Gini A, Pedrolli C, Vanotti A. Publication Dates Publication in this collection Jul-Aug History Received 26 Oct Reviewed 17 June Accepted 27 July This is an open-access article distributed under the terms of the Creative Commons Attribution License.

Karina Díaz Leyva de Oliveira Escola Superior de Ciências da Saúde, Fundação de Ensino e Pesquisa em Ciências da Saúde FEPECS , Programa de Residência em Nutrição Clínica.

Brasília, DF, Brasil. Escola Superior de Ciências da Saúde Brazil Brasília, DF, Brazil Escola Superior de Ciências da Saúde, Fundação de Ensino e Pesquisa em Ciências da Saúde FEPECS , Programa de Residência em Nutrição Clínica.

Adriana Haack Escola Superior de Ciências da Saúde, Secretaria de Estado de Saúde do Distrito Federal. Escola Superior de Ciências da Saúde Brazil Brasília, DF, Brazil Escola Superior de Ciências da Saúde, Secretaria de Estado de Saúde do Distrito Federal. Renata Costa Fortes Escola Superior de Ciências da Saúde, Secretaria de Estado de Saúde do Distrito Federal.

Correspondence Karina Díaz Leyva de Oliveira E-mail: karinadloliveira gmail. Escola Superior de Ciências da Saúde, Fundação de Ensino e Pesquisa em Ciências da Saúde FEPECS , Programa de Residência em Nutrição Clínica. Escola Superior de Ciências da Saúde, Secretaria de Estado de Saúde do Distrito Federal.