Get patients excited about amino acids

Four events depend on acids intake

Providers developing nutritional assessment tools should include a means to track amino acid intake among wound care patients, says Rita A. Frantz, PhD, RN, FAAN, associate professor of nursing at the University of Iowa in Iowa City.

"Nutrition plays a significant role," insists Frantz, who served on the federal Agency for Health Care Policy and Research (AHCPR) panel preparing the clinical practice guidelines used by health care providers. AHCPR’s guidelines for treating and preventing pressure ulcers was published in 1992.

When it comes to wound healing, Frantz says quality managers should emphasize three elements on the nutritional assessment:

1. protein for wound repair and regeneration;

2. fats and carbohydrates to keep amino acid levels appropriate;

3. glucose for energy.

Amino acids are essential

Angiogenesis, fibroblast proliferation, collagen synthesis, and scar remodeling cannot occur without essential amino acids, Frantz says. An increased protein metabolism spurred by tissue injury often means additional dietary sources are necessary for patients with chronic wounds, she says. In addition, patients need fats and carbohydrates to prevent the amino acids from being oxidized for calorie needs.

Frantz explains that albumin is the single most important indicator of malnutrition because when protein intake is inadequate, the albumin is sacrificed to provide essential amino acids. Another important test is a lymphocyte count. She recommends nutritional supplements when the lymphocyte count drops to 1,800, adding that a lymphocyte count of less than 800 is an indicator of severe malnourishment.