Nutrition in patients with chronic non-healing ulcers: a paradigm shift in wound care

Thomas E Serena,1 Raphael A Yaakov,1 Mark DeLegge,2 Tim A Mayhugh,1 Sarah Moore1 1SerenaGroup, Cambridge, MA, USA; 2Nutritional Healing LLC, Nashville, TN, USA Abstract: Chronic ulcers continue to pose a significant clinical and economic burden for both patients and wound care practitioners. Despite good standard of care (SOC), many wounds fail to heal. Wound healing requires a complex cascade of physiologic and immunologic processes as well as proper nutrition. An adequate balance of macro- and micronutrients is important to support the cellular activities that are necessary for repairing and remodeling of tissue. Despite being well documented in a number of clinical studies there continues to be a gap in recognizing nutritional deficits as well as appropriate clinical interventions in patients with chronic wounds. Effective management of malnutrition in patients with chronic wounds requires collaboration among multiple clinical disciplines. A holistic nutritional management approach may yield both clinical and economic benefits. Keywords: wound care, chronic wounds, parenteral nutrition, micronutrients, macronutrients, wound healing, nutrition management, malnutrition, nutrition assessmen