Role of nutritional intervention in negative pressure wound therapy (NPWT). Case report of patient treated by 'open abdomen' method.

Abstract

Introduction
 Wound healing process depends on many factors. As it has been proved many times before, nutrition is one of the key factors in wound healing therapy. When there is an insufficient supply of nutrients and malnutrition, wound healing processes slow down and the inflammatory phase is prolonged, which requires high energy expenditure and as a consequence may lead to the loss of lean body mass and the development of sarcopenia and cachexia. This promotes the formation of non-healing chronic wounds.
 In this paper, we would like to emphasize the role of nutrition, as an integral part of wound healing processes, which should encompass the current metabolic needs associated with patient’s clinical condition.
 This case describes a young male patient with gastrointestinal tract insufficiency and an extensive postoperative wound treated by the open abdomen method. In the course of increased catabolism, water and electrolyte loss and disturbances as well as nutritional insufficiencies, body mass loss and progressive cachexia occurred in this patient and, as a consequence, the wound healing processes was significantly diminished. 
 Inducing and maintaining the anabolic processes in the organism and control of the enhanced catabolism in response to metabolic stress or injury are essential actions in optimizing the treatment and healing process. These are possible to achieve by the early introduction of balanced and individualized nutritional treatment regimens, provision of the energy and appropriate nutrients, which enables the restoration of lean body mass and stimulation of the healing processes.