Impact of Dehydration on Wound Healing

What is the role of water?
Water plays a vital role in our overall health and may be the most important nutrient of life. Roughly two-thirds of our body is comprised of water. Since the body is not capable of storing water, daily replacement of lost fluids is needed for cellular functions such as delivering nutrients and oxygen to the cells, removing waste products and toxins, lubricating joints, protecting the central nervous system, retaining acid base balance and maintaining adequate tissue temperature. (3) Sufficient oral intake of water is vital to these functions.  

What is one of the most common, unrecognized obstacles impacting successful wound healing?
If you answered dehydration you would be correct. More than 1/3 of America’s seniors do not consume enough water. (8) The human body can survive for weeks without food but will only exist a few days without water.   Simply, dehydration occurs when more water (fluid volume) is lost than is replaced. (6)   Dehydrated skin is known to be more fragile, less elastic and susceptible to wound occurrence. (2)

How are seniors affected?
Water intake in the senior population can be impacted by decreased sensation of thirst, fear of incontinence,   diminishing cognitive skills,   or physical limitations that inhibit their ability to pour and drink water, even when placed nearby.  Also, disease processes, medications, heavily draining wounds, illness involving fever, vomiting or diarrhea or decreased kidney function can negatively impact hydration in the this population. (5) Additionally, highly specialized air fluidized therapy beds used for persons with serious wounds or surgical repairs may increase the evaporation of body fluids requiring additional fluid intake. (7)  Drops in fluid volume of 1-2 % can trigger fatigue, while drops of 10% or more may severely impact all areas of health. (7)   The ability to heal wounds suffers because of decreased oxygenation, cellular communication, or electrolyte functions that negatively impact the ability of the wound to progress through the stages of wound healing. (1)

How can we help?
We can’t ignore the impact of diminished thirst in the aging population. Thirst is the mechanism to tell us our body is in need of fluid. (6) Unfortunately, the body can be 1 or 2 percent dehydrated before the thirst mechanism becomes active. The average water requirement for an adult is about 1,500 ml daily or eight 8 ounce glasses. More accurately, fluid needs should be based on weight; adults should consume 30 ml/kg of fluids per day. (2) Keep in mind that some fluids hydrate better than others, for example, those containing caffeine may have a diuretic effect. (7)  Some simple hydration tips include:

• Keep drinks accessible
• Provide straws or easy to remove capped lids
• Offer assistance frequently when needed
• Encourage consumption of water packed foods, such as jello, soup, fruit
• Note personal preferences, ice or no ice, types of liquids, and flavors to encourage intake
• Offer meals at preferred eating times
• Encourage fruits and vegetables;   they are an important food source for hydration.

When using air fluidized beds, mitigate the risk of dehydration by consulting with the bed provider for training and support.

Optimize topical wound care
Keep dry wound beds hydrated with products that provide additional moisture, such as DermaRite’s DermaSyn products. DermaSyn Gel, DermaSyn Ag and DermaGauze are excellent options for meeting the needs of dry wound beds. DermaSyn and DermaSyn Gauze are water based gel formulas, enriched with vitamin E to donate moisture to a dry or minimally draining wound bed. DermaSyn Ag contains ionic silver to minimize microorganism growth. DermaSyn products promote an optimal moist wound environment, facilitate autolytic debridement and support new tissue development. Visit our website at www.dermarite.com to learn more about DermaRite products.

References

1. Today’s wound care: a review.. (n.d.) >The Free Library. (2014). Retrieved Feb 23 2016 from http://www.thefreelibrary.com/Today%27s+wound+care%3a+a+review.-a019446345
2. Wotton, Karen; Crannitch, Karina et al., Prevalence, risk factors and strategies to prevent dehydration in older adults. Contemporary Nurse : a Journal for the Australian Nursing Profession, December 1, 2008
3. Water: The essential nutrient. Retrieved Feb 23, 2016 from http://swine.missouri.edu/nutrition/water.htm
4. Dorner B., Creative nutrition: Solutions for failure-to-thrive patients. Aging Well
   3 No. 4 P. 8
5. Borreli, L., Lack of drinking water, Retrieved Feb 22, 2016 from http://www.medicaldaily.com/pulse/lack-drinking-water-deteriorates-human-body-adverse-effects-dehydration-329640
6. Batmanghelidi F., Optimal hydration. (2011) Retrieved Feb 23, 2016 from http://www.realfoodwholehealth.com/2011/04/optimal-hydration/
7. The role of nutrition in tissue viability. (2007) Retrieved Feb.23, 2016 from http://www.woundsinternational.com/media/issues/217/files/content_182.pdf
8. Older Americans do not drink enough water. (2002) Retrieved Feb. 22, 2016 from http://www.cnpp.usda.gov/sites/default/files/nutrition_insights_uploads/Insight27.pdf

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