Department of Nutrition and Dietetics Patient Information Service

Diet and Pressure UlcersA Advice for Patients & Carers

Abertawe Bro Morgannwg NHS Trust is committed to preventing patients developing pressure ulcers. This information sheet contains the best dietary advice currently available to help patients avoid developing a pressure ulcer.

Pressure ulcers are caused when the skin and underlying tissues are damaged, however you are at a higher risk of developing a pressure ulcer if you are not eating and drinking enough.

Good nutrition makes the skin healthier and more resistant to ulcers. A healthy balanced diet is therefore very important

This leafl et contains some tips and ideas to help make sure you are eating the best you can to prevent developing a pressure ulcer.

The Eatwell PlateAim to balance your diet by choosing from the food groups in the picture below

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JANUARY

NewYear ResolutionsPlenty of fruit and vegetablesFresh, frozen, tinned, dried and a glass of pure fruit juice all count towards your five-a-day.

Meals based on starchy foodsThese include bread, rice, potatoes andpasta. Try to go for wholemeal options which will keep you fuller for longer.

Some milk and dairy foodsA pot of yogurt, small piece of cheese orglass of milk - try to choose the low fat options, eat full fat options less often, or have smaller portions.

Some meat, fish, eggs and beans and other sources of proteinThese foods also contain many vitamins and minerals.

A small amount of sugar and fatEat just a small amount of foods and drinks high in fat and/or sugar. Sugar is high in calories and can cause tooth decay. Check the labels - 15g of sugar per 100g is high and 5g of sugars or less per 100g is low.

Tips andhints• Getting active will help burn off excess

calories and helps control our weight.

• No excuses - going for a good walk or run is free!

• Remember to drink plenty of water - about 6 - 8 glasses every day to stop you getting dehydrated.

RecipeCouscous SaladCouscous salad is simple and quick to prepare and covers all the food groups in the eatwell plate. It is great as a meal in itself, and transports well in a lunchbox.

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Ingredients350ml water, boiling 200g couscous 2 spring onions 1 yellow pepper 1 cucumber 2 medium tomatoes6 dried apricots 1 tin chickpeasChunks of feta cheese2 x 15ml spoons parsley 2 x 15ml spoons low fatdressing such as vinagrette

Method1. Pour the boiling water over the couscous in a large bowl. 2. Fluff with a fork and leave to stand for 5 minutes. 3. Chop the tomatoes and cucumber into small chunks. 4. Slice the pepper into small strips. 5. Slice the dried apricots and parsley into small pieces. 6. Add all the vegetables, chickpeas and chunks of feta cheese

to the couscous and snip the spring onions into the bowl using the scissors.

7. Stir everything together. 8. Add the dressing.

Serves 4-6

This year I will try to eat...

Vitamin C and Zinc

Vitamin C has many roles to play in the formation of new tissue and wound healing.

Make sure you are getting enough in your diet by including foods rich in vitamin C and zinc.

If you don’t think you have enough of these foods in your diet, then you may need to take a multivitamin or supplement. Ask your health care team for advice.

Food High in Vitamin C:• Citrus fruits

e.g oranges, kiwi • Vegetables

e.g broccoli, peppers • Fruit juice • Tomatoes • Berries

e.g strawberries

Food High in Vitamin Zinc:• Red meat• Unrefi ned cereals• Milk and dairy products• Eggs• Green leafy vegetables• Beans

• Adding jam, syrup or honey to breakfast cereals and milk pud-dings.

• Adding sugar or glucose powder (which is less sweet tasting) to desserts and drinks.

No appetite?

If you are fi nding it diffi cult to eat or drink enough, talk to your healthcare team. They may be able to arrange for you to have spe-cial ‘Nutritional Supplements’ on prescription.

You may also need a multi-vitamin/mineral supplement to make sure your body gets these important nutrients. Ask your health-care team for advice.

What if I’m overweight?

Carrying a lot of weight places more pressure on your body, espe-cially if you are not able to move around very much.Try keeping to a balanced diet and reduce your intake of fat and sugar. Increasing your intake of fruit, vegetables and high fi bre foods will help reduce hunger and help you lose weight sensibly.

What if I have diabetes?

As well as good nutrition, good blood glucose control will help wound healing and help prevent pressure ulcers developing.

Protein

Protein is essential to help the body make new tissue. When we don’t eat enough protein our tissues become weaker and when damaged, are slower to heal.

To make sure you are eating enough protein try to have a balanced diet, including a protein food at each meal.

Some protein foods are listed below

• Meat• Fish• Cheese• Eggs• Pulses• Lentils/Beans

Fluid

When we become dehydrated our skin becomes less elastic, fragile and more susceptible to breakdown.

You should drink at least 6-8 glasses (1.5 litres) of water or other fl uids each day to stop you becoming dehydrated.

Keep a drink beside you and sip it regularly.

Iron

Iron is essential in our diet to prevent iron deficiency anaemia.

If we become anaemic our tissues will not be able to receive oxygen as well as normal.

Make sure you are having enough iron in your diet by having plenty of iron-rich foods

To increase the absorption of iron from our food, have food or drinks high in vitamin C as part of your meal. Avoid tea with meals as this will reduce the absorption of iron in the body.

Foods High In Iron• Red meat• Liver and offal meats• Poultry• Green leafy vegetables• Dried fruit• Fortified breakfast cereals

Energy

Pressure ulcers are more likely to develop if you are under or overweight.

If you are underweight, have lost weight or have a poor appetite, then it is likely that there are less fat stores around your body. Fat stores act as ‘cushions’ around our bones and when they are depleted, damage to our tissues can occur much more easily.

To help restore these fat stores try some of the suggestions listed below:

• Try eating little and often. 5-6 smaller snacks spread through-out the day are easier to manage if you have a poor appetite.

• Choose high energy/high protein snacks in between meals e.g cheese and crackers, full fat yoghurt, cakes or biscuits.

• Have a nourishing drink such as milkshake or milky coffee in between meals.

Fortify your meals and snacks by:

• Adding 4 tablespoons of dried milk powder to 1 pint of milk to make enriched milk. Use this throughout the day for cereals, puddings and in drinks.

• Adding grated cheese to soups, casseroles and mashed potato.• Adding double cream to soups, sauces, mashed potato and

desserts.• Adding butter or margarine to vegetables, pasta and scrambled

egg.