Nutrition support for wound healing in the intensive care unit patient

Miriam Theilla*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


The integumentary system is not considered immediately vital to the survival of the acutely and critically ill patient. The skin, however, is a vibrant organ that functions as a physical and immunological barrier between the external world and the sterile underlying tissues. Preclinical and observational studies depict the deleterious effect of insufficient energy, protein, and micronutrients on wound healing and on pressure ulcer (PU) burden, and demonstrate that serious PUs raise patients' daily energy expenditure. In addition, several randomized controlled trials (RCTs) have assessed the impact of a nutritional intervention on the incidence and healing of PUs. RCTs have been heterogeneous vis- à- vis patient population and healthcare setting, methodological quality, type (e.g. single vs. multiple nutrients) and duration of nutritional support, method of PU assessment, etc. Most studies evaluate oral supplementation in hospitalized patients and institutionalized elderly. The paucity of RCTs focusing on intensive care unit (ICU) nutrition in the support of wound healing and the prevention of pathologic healing precludes formulation of evidence-based guidelines for clinicians. Nevertheless, supplying ICU patients with at-least the required quantities of calories, protein and micronutrients (in accordance with ICU nutrition guidelines) can be endorsed with sufficient certainty, in order to prevent and treat PUs. Initial evidence suggests that immunonutrition that includes long-chain omega- 3 fatty acids may prove to be cost-effective in preventing PUs in high-risk patients, and in treating existent ulcers.

Original languageEnglish
Title of host publicationNutrition in Intensive Care Medicine
Subtitle of host publicationBeyond Physiology
EditorsPierre Singer
PublisherS. Karger AG
Number of pages11
ISBN (Electronic)9783318022285
ISBN (Print)9783318022278
StatePublished - 1 Oct 2012
Externally publishedYes

Publication series

NameWorld Review of Nutrition and Dietetics
ISSN (Print)0084-2230
ISSN (Electronic)1662-3975


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