The largest organ of the human body is not inside of it, it covers it. Skin covers an area of approximately twenty five square feet and weighs, on average, about six pounds. The skin is vital to our health and well being by providing a protective barrier against germs, bacteria, and viruses. It also protects the more delicate tissues and organs beneath it from harm, regulates the temperature of the body, and helps to rid the body of some of its waste products. The skin also protects the body from some of the harmful effects of ultraviolet radiation and transforms sunshine to Vitamin D. (Source: MacLean, editor, 1993)
Burns are one of the most common types of injury that can befall the skin- and can range from a simple, first-degree burn to a life threatening third-degree burn. Any second-degree burn that is larger than a quarter on a child or a silver dollar on an adult and all third degree burns should be evaluated by the hospital immediately to reduce the risk of infection and further complications.
Whether you have to stay in the hospital or not, there will be some increases in your dietary needs – the more of your skin that is burned, the higher the needs will go. A burn that is 20% or more of the total body surface area (TBSA) will increase the body’s energy (calories) demands by one and a half to 2 times of the normal amount. The tissues can break down very quickly and can lead to serious nutritional deficits. Protein is one of the nutrients that will be deficient as will a number of other vitamins and minerals depending on the severity of the burn. (Source: Feinstein, 1996)
In most cases, the burn victim will be given a high calorie, high protein diet that will help keep up with the nutrients that are being consumed as the body frantically works to rebuild itself. A burn will speed up your metabolism at a rate that is roughly 118-210% over that of the Harris-Benedict Equation. This is a mathematical equation that helps determine necessary calories to maintain body weight. The number is adjusted up or down according to body weight needs. For instance, if the body is overweight, decreasing calories can help to lose weight.
In a burn that is covering a quarter of the body’s total surface area, the resting metabolic rate can be over 5000 calories per day. With over 40% of the body covered, a burn victim can lose up to a quarter of the body weight in three week’s time without nutritional support. It is important to note that with losses of body weight that are over ten percent, the outcome is not generally favorable because of an impaired immunity and delayed healing, both of which greatly increases the chance of a fatal infection.
Nutritional Guidelines for Burn Victims
The adult burn victim will need at a minimum of 25 calories per kilogram of their weight plus 40 additional calories per percentage of burned area. For a child, the overall calorie need would be 1800 calories plus 2200 calories per millimeter of burned area. Both adults and children may need more than these amounts if more than twenty percent of the body has been burned.
Majority of the most severely burned victims will be fed via feeding tubes that are placed shortly after their admission into the hospital. The suggestion that feedings should start within four to thirty six hours after the injury in most cases has been made because of a number of benefits in associated with the practice. Once the patient is hemodynamically stabilized, the early feedings will:
– Decrease the chance of sepsis (a serious, systemic infection that is often the cause of death in hospitalized patients)
– May shorten hospital stays for some patients
– Decrease burn related catabolic hormones
– Maintains gut mucosal integrity
Feedings should be done using the duodenal route which is better tolerated than gastric feedings which have an 18% failure rate because of regurgitation. Total parental feedings are not recommended in most cases as they do not prevent the catabolic response to the burns and may impair immunity and liver function. In addition, total parental feedings have an increased mortality rate mainly because of these complications.
A high calorie, low fat diet will lead to less proteolysis keeping lean muscle mass intact and may also lower infectious mortality. However, the patient will still need to be monitored for hyperglycemia and will typically be given an insulin drip to monitor and maintain blood glucose levels.
The patient’s protein oxidation rate may climb as high as fifty percent more and may need at least 1.5-2 grams of protein per kilogram of the body weight. In addition, the patient’s water and fluid needs will be greatly increased as well. The burn victim can lose up to four liters of water and body fluids per day from a number of sources including wound seepage and blood loss. These losses can also increase mortality by leading to serious dehydration and electrolyte imbalances. (Source: Nutrition MD)
Protein Supplements Both In and Out of the Hospital
Protein is needed to be supplemented for the burn victim, not only to maintain lean muscle mass but so that the body can work to repair the skin. Protein is also a major component of the immune system. While in the hospital, the feedings will be continued until the body starts healing and the patient is better able to tolerate actual foods in the amount that is needed. A high protein supplement can be used as part of the feeding but should be one that can be tolerated when regular foods are resumed as well. Increased protein needs will continue until the body is completely healed from the burn and may persist for sometime thereafter, depending on health status.
Some protein supplements may not be as tolerable to the burn victim as others, especially those that have additional ingredients that reduce the overall nutritional value. Profect, from Protica is often used in medical settings, including hospitals, and is available in a number of strengths and flavors that can be used as a feeding supplement as well as consumed by the patient. A ten serving bottle can be used as is or mixed with fruit juice, water, or other supplements as needed. Smaller servings are also available including a one serving, 25 gram protein supplement shot.
Profect is also beneficial because it is easier for the body to use, is hypoallergenic and has the full spectrum of water soluble vitamins. There are zero carbohydrates and zero fats in this supplement. Flavors include: Blue Raspberry Swirl, Grapefruit Mango, Fresh Citrus Berry, Cool Melon Splash, Passion Fruit, Orange Pineapple, Ruby Melon Twist and Fuzzy Peach Nectar.
Protica Research (Protica, Inc.) specializes in the development of Capsulized Foods. Protica manufactures Profect, IsoMetric, Pediagro, Fruitasia and over 100 other brands, including Medicare-approved, whey protein supplements for bariatric patients. You can learn more at Protica Research – Copyright