Write a literature review on a selected topic. The assignment should be written based on the chosen PICO question based on evidence-based practice. More detailed guidelines and the PICO question will be updated asap.

Wound management is a significant and growing health burden on the community,
and it is becoming more challenging to control. Increasing hospitalizations and dependence
on wound care have resulted in an enormous cost load on the healthcare system. Having a
chronic wound substantially impacts the quality of life and social relationships of both the
patient and the caregiver. Consequently, the diet should be regarded as an essential aspect of
wound therapy since it substantially influences the healing of wounds and the procedures
employed in their care (Smith, 2014). Furthermore, as compared to hospitalization, feeding is
a more cost-effective option. Poor nutrition during wound care causes the healing process to
be delayed and the wound strength to be reduced, making the wound more susceptible to
disintegration. It is hoped that integrating best nutrition practice provision with wound
treatment expertise would assist healthcare professionals in minimizing the mortality and
morbidity associated with chronic wounds and the effect and expense associated with these
conditions.

A chronic wound requires more than 4-6 weeks to heal and is classified as such by the
medical community. Examples of chronic wounds that might become chronic if not managed
with proper healthcare practices include venous leg ulcers, stomas, post-operative wounds,
ulcers on the feet and legs, and long-term burns that have not healed completely (Steed,
2013). These wounds significantly influence the economic, social, and healthcare burdens in
the United States and globally, particularly in developing countries. Such wounds may
develop in persons of all ages, although they are more common among the elderly and the
chronically sick than in the general population (Richard et al., 2017). When you consider the
growing older population as well as the rising frequency of chronic illnesses, wound
management becomes a big challenge for healthcare institutions to deal with as one of the
predisposing variables, diabetes (which causes ulcers on the legs and feet), has grown in
prevalence between 1981 and 2012, with an estimated 9.3 percent of the population in the

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United States being diabetic (Steed, 2013). On the financial front, it is estimated that the
economic cost of diagnosed diabetes is $245 billion, indicating that there is a more significant
need to treat these wounds via an appropriate diet.

It is undeniable that proper dietary habits play a crucial part in healing wounds and
injuries. This process is extended and hampered if proper nutrition is not provided since it is a
process that includes the replacement of wounded tissues with new tissue, which necessitates
the ingestion of certain nutrients such as calories and proteins, as well as an increase in
energy consumption (Williams & Barbul, 2012). The healing process is influenced by the
wound, which might include changes in lipid, vitamin, energy, mineral, protein, and
carbohydrate metabolism, among other things.

Being well-nourished has been linked to better health, independence, and general
wellbeing, critical for older adults. Nutrition is a critical player in preserving skin tissue,
strengthening tissue resistance, and promoting tissue healing, among other things (Williams
& Barbul, 2012). Wound healing relies heavily on regenerating the skin, and sufficient
nourishment is essential for this process. Wound healing is thus dependent on the availability
of proper nutritional support. In contrast, two randomized controlled trials done in individuals
with PUs found that particular nutrients play an active role in wound healing regardless of
protein and calorie consumption (Touger-Decker, Sirois & Mobley, 2012). A high arginine,
protein, and micronutrient-enriched oral nutritional supplement (ONS) were given to PU
patients who were not malnourished, much as those who got it in the van Anholt et al. study,
which had positive outcomes. With fewer dressings and less time spent changing them, PU
treatment is projected to be more cost-effective because of reduced wound care intensity and
faster healing rates for the wounds. More arginine and zinc were shown to improve the
recovery of malnourished PU patients who got nutritional supplements. Micronutrients were

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supplied in the context of proper nutritional care, and both groups received a similar high-
protein, high-calorie support to induce new tissue growth in this large multicenter, blinded
randomized controlled trial (RCT).

PICOT Question

This research aims to identify the effect of nutrition in the healing of wound