Tissue viability - Dementia Care Research

Nutrition and skin health – learning from ANTS training day

A great opportunity came up for me when I was invited to present at the Agents for Nutrition and Tissue Viability Study day (ANTS) at the Royal Bournemouth Hospital last Tuesday. If you read my previous blog post Understanding Eating in Dementia – more than just memory loss, you will get a brief overview of what I talked about!

Aside from my own presentation, however, it was the rest of the day that I particularly enjoyed. I loved hearing how nutrition is so relevant to such a range of topics – Acute Kidney Injury, Diabetes, Stroke, Tissue Viability – and developing my knowledge about PEG feeding and Nasogastric tubes! 

Care of older people is complex and I would challenge anyone who claims they don’t want to work in older person’s medicine for fear that it would be boring!

My favourite sessions were from the tissue viability nurse; skin integrity is such a complex issue and nutrition plays such an important part!

Tissue viability

For the non health/medic people out there, this is basically skin health. It’s sadly common for older people especially (though not exclusively) to have skin damage through not having healthy skin.

The damage can develop from pressure on a particular area, from friction/shearing on movement or because of prolonged moisture exposure. Often older people, especially those who are unwell in hospital, are at a high risk of skin breaking down and developing sores, which can lead to complex health issues.

“Wounds can heal without dressings” – TV Nurse Specialist

There are various ways of keeping skin healthy – changing position regularly, good personal hygiene, correct moving and handling… and nutrition! Keeping the skin nourished and hydrated is a massive part of wound prevention, but what about healing?

Nutrition and wound healing

The best bit of the talk, for me, was when the tissue viability nurse made the controversial claim (from a nurses perspective anyway!) that wounds can heal without dressings.

I’m not a nurse and don’t know a lot about wounds, so here’s my number one piece of learning of the day! Nutrition is essential in the healing process!

What nutrients does the body need for each stage of wound healing?

  1. Haemostasis (blood clotting)
    – energy
    – protein
    – vitamin K
  2. Inflammation (blood vessels dilate to allow nutrients to reach the wound)
    – vitamins A, C and E
    – selenium
    – antioxidants
    – energy
    – protein
  3. Proliferation (granulating tissue)
    – energy
    – protein
    – copper
    – iron
    – vitamins A, B6 and C
    – zinc
  4. Remodelling/maturation
    – energy
    – protein
    – zinc
    – vitamin C
    – iron

I hope that is useful information for all you health professionals or people looking after loved ones with skin sores. Isn’t the body a fascinating thing!?

And remember – when people with dementia are on hospital wards they especially need our help to stay nourished!


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