Patient must ingest a sufficient amount of calories because the chemical reactions during wound healing are very energy-intensive.

Especially the following nutritional elements are important for the wound-healing process:

Proteins:
If not enough proteins and amino acids are supplied, protein synthesis and thus the proliferation of cells of granulation tissue are interrupted. The function of the immune defense cells is also limited. Protein deficiency impairs all wound-healing processes.

Vitamins:
Even the deficiency of only one single vitamin can delay healing. B complex vitamins take part e.g. in collagen synthesis and stimulate antibody formation and infection defense. Antioxidants such as vitamin E and vitamin C absorb so-called free radicals which are toxic for the epithelial cells. Vitamin A takes effect during collagen synthesis and cross-linking. Vitamin C is also important during the synthesis of collagen as well as of intercellular substance, basal membranes of vessels, complement factors, and gamma globulins.

Minerals:
Among minerals, particularly zinc and iron deficiencies cause disruptions. Zinc is a central component of so-called metalloenzymes with significant biological effects in the organism and therefore it plays a decisive role in wound healing. Iron deficiencies cause anemia, thus reducing oxygen transport into the wound area.

Calories:
The chemical reactions during wound healing are very energy-intensive. If there are not enough carbohydrates available for energy production, a conversion to catabolic metabolism occurs. The body's own high-quality muscle proteins are catabolized for the production of energy by means of the gluconeogenesis mechanism. Even after a short period of bed rest (1 to 2 weeks), this leads to severe protein deficiency and amyotrophia.

The cause of the nutritional deficit must be clarified together with the patient.

The goal is to convert the metabolism from catabolism to anabolism with a special nutritional therapy during wound healing. In the process the primary causes of catabolism in the individual patient must be identified and treated or eliminated. This can include an antibiotic therapy of infections, measures against isolation, treatment of depression or of cardiac insufficiency.

The existing nutritional deficit is determined by exact diagnosis, and then the form and access of nutrition must be defined. Basically four possibilities are available:
• Sufficiently normal food,
• nutrition largely or partly using fully balanced, supplementary liquid food in a sufficient quantity and number of calories,
• tube feeding via PEG
• or total parenteral nutrition.
Which method is chosen depends on the patient’s condition and wishes.