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Treatment > Nutrition for Patients

The three major nutritional factors that play a key role in recovering from burn injuries are total calories, protein & vitamins, and minerals.

Total calories

Burn injury is the single most stressful event the human body can suffer. Depending on age, size, gender and the size of the burn, energy expenditure for wound healing can equal as much as that required to run 20 to 30 km. Imagine needing to fuel your body with that many calories — all while lying in bed! This is why meeting caloric requirements during recovering — especially if the burn is greater than 20% TBSA (Total Burn Surace Area) — is so challenging. When burns are this great (and despite initial enthusiasm to eat all those calories) most people fail to meet their requirements. This leads to delayed wound healing, higher infection rates, massive weight loss and prolonged rehabilitation due to loss of lean muscle mass. To prevent this situation, a feeding tube is often used, which can deliver liquid nutrition 24 hours a day. These tubes enter through the nose and terminate in the stomach or intestine.

Protein

There are three ways in which the body obtains calories (fuel) from food:

1. Carbohydrates - bread, pasta, rice, potato, cereal, other grains
2. Protein - meat, fish, eggs, dairy, nuts, seeds, tofu, beans
3. Fat - oils, butter, margarine, animal fats

The most important fuel for burn recovery is protein. Skin is protein, and therefore, eating protein supplies your body with the proper materials to build and repair damaged skin. Protein-rich foods should be the focus of every meal and snack. Since protein doesn't come in a pill, it must be obtained through foods or high-protein feeding formulas. For patients with burn injuries, rotein requirements are usually between 1.5 and 2.2 g/kg of body weight. Failure to meet protein requirements leads to delayed wound healing, poor blood protein levels, and the breakdown of lean body mass and internal organs.

Vitamins and Minerals

Vitamin A, Vitamin C and Zinc play a significant role in repairing and building of skin. Since recommended doses for would healing are too large to achieve through food alone, supplements in pill form are provided. Foods that are high in vitamins and minerals are low in protein, so this may be the only instance where a Dietitian is not pushing you to eat more fruits and vegetables!

Thinking of bringing in food for a burn patient? Here are some suggested guidelines:

• Meat of almost any description - hot or cold, in a sandwich, hamburger, pita or salad, on a pizza or in soup
• Dairy products including milk, flavoured milk, milkshakes, yogurt, yogurt drinks, cheese
• Soy milk - flavoured or unflavoured
• Fish of any kind, fresh or canned
• Eggs — cooked only
• Legumes such as peas, beans, lentils, peanuts in casseroles, wraps, falafel, hummus, soups
• Tofu in soups, casseroles, stir-fry, tempeh, sweetened dessert, or in fruit smoothies
• Nuts and seeds - canned or fresh nuts, seeds, trailmix, peanut or other nut butters, tahini or other seed butters
• Commercial supplements such as liquid nutritional supplements or energy bars containing more than 8 grams of protein per bar

Food suggestions for children

• Milk (plain or flavoured) or milkshakes
• Cheese strings
• Yogurt tubes, Mini-Go yogurt or frozen yogurt,
• Puddings made with Fortified milk*
• Hamburgers with cheese
• Pizza with meat and cheese
• Spaghetti with meat sauce
• Macaroni and cheese made with Fortified milk*,
• Chicken fingers

* Fortified milk is Homogenized milk with Skim milk powder added for extra protein (1/4 cup Skim milk powder for every cup of milk)