Pressure injuries are common complications in patients with limited mobility, particularly those who are bedridden. These wounds not only cause pain and reduce quality of life but also lead to prolonged hospitalization, increased risk of infection, and higher healthcare costs. Among the various contributing factors, malnutrition plays a crucial role by impairing collagen synthesis, weakening immune function, and delaying tissue repair. Adequate nutritional support—particularly sufficient protein and energy intake—is therefore an essential component of comprehensive pressure injury management. We present the case of a paraplegic patient who developed a vulvar pressure injury. A structured, stepwise nutritional intervention was implemented, including adjustment of meal composition based on appetite, supplementation with high-protein oral nutritional supplements, vitamins and minerals, and the use of probiotics to manage diarrhea. As a result, the patient’s daily protein intake increased from less than 10 g to 80–90 g, accompanied by progressive wound improvement. Serial clinical assessments showed reduced slough, increased granulation tissue formation, and epithelialization. This case highlights the vital role of individualized nutritional management within a multidisciplinary approach to pressure injury care. Stepwise nutritional intervention, tailored to the patient’s tolerance and clinical status, contributed significantly to wound healing. Nutritional optimization should be considered an integral component of effective pressure injury treatment strategies.
Critically ill trauma patients generally show good nutritional status upon initial hospitalization. However, they have a high risk of malnutrition due to hyper-metabolism during the acute phase. Hence, suitable nutritional support is essential for the optimal recovery of these patients; therefore, outcomes such as preservation of fat-free mass, maintenance of immune functions, reduction in infectious complications, and prevention of malnutrition can be expected. In this report, we present the experience of a patient subjected to 40 days of nutritional interventions during postoperative intensive care unit (ICU) care. Although the patient was no malnutrition at ICU admission, enteral nutrition (EN) was delayed for > 2 weeks because of several postoperative complications. Subsequently, while receiving parenteral nutrition (PN), the patient displayed persistent hypertriglyceridemia. As a result, his prescription of PN were converted to lipid-free PN. On postoperative day (POD) #19, the patient underwent jejunostomy and started standard EN. A week later, the patient was switched to a high-protein, immune-modulating formula for postoperative wound recovery. Thereafter, PN was stopped, while EN was increased. In addition, because of defecation issues, a fiber-containing formula was administered with previous formula alternately. Despite continuous nutritional intervention, the patient experienced a significant weight loss and muscle mass depletion and was diagnosed with severe malnutrition upon discharge from the ICU. To conclude, this case report highlights the importance of nutrition interventions in critically ill trauma patients with an increased risk of malnutrition, indicating the need to promptly secure an appropriate route of feeding access for active nutritional support of patients in the ICU.
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