Gruen Douglas
Rx Nutritional Solutions, LLC, Indianapolis, IN 46250, USA.
J Am Col Certif Wound Spec. 2010 Feb 12;2(3):46-9. doi: 10.1016/j.jcws.2010.11.001. eCollection 2010 Sep.
As the largest organ of the body, the human skin protects all subcutaneous tissues. Despite its many attributes, the skin is vulnerable to pressure ulcers. The number of pressure ulcers and venous leg ulcers is on the rise, but healing rates have not improved over the past decade. The reason may be a tendency to focus on one or two fundamentals of wound healing, but not on all 3 fundamentals equally. The 3 fundamentals of wound healing are (1) pressure relief and nursing care, (2) dressings, and (3) nutrition. Nutrition is the area that is most often overlooked, which commonly causes the care plan to be out of balance. In the United States, few clinicians would consider malnutrition to be an issue in the homecare and long-term care setting, yet nutritional status and risk for pressure ulcer formation are well documented and strongly correlated. Our aging population will continue to survive previously catastrophic events, only to present with pressure ulcers or the potential for developing pressure ulcers. Clinicians caring for residents with pressure ulcers must strike a balance between pressure relief, dressings, and nutrition. Functional gastrointestinal-tract impairments must be diagnosed and addressed. Wounds must be treated aggressively with high-protein calorically-balanced diets because wounds heal from the inside out.
作为人体最大的器官，人类皮肤保护着所有皮下组织。尽管皮肤有诸多特性，但它仍易患压疮。压疮和下肢静脉溃疡的数量在不断增加，但在过去十年中愈合率并未提高。原因可能是倾向于关注伤口愈合的一两个基本要素，而没有同等重视所有三个基本要素。伤口愈合的三个基本要素是：（1）减压与护理，（2）敷料，（3）营养。营养是最常被忽视的领域，这通常会导致护理计划失衡。在美国，很少有临床医生会认为营养不良是家庭护理和长期护理环境中的一个问题，然而营养状况与压疮形成风险之间的关联已有充分记录且密切相关。我们的老龄人口将继续在先前的灾难性事件中存活下来，却会出现压疮或有发生压疮的可能性。照顾患有压疮患者的临床医生必须在减压、敷料和营养之间找到平衡。必须诊断并处理功能性胃肠道损伤。伤口必须通过高热量平衡的高蛋白饮食进行积极治疗，因为伤口是从内部开始愈合的。
