The Correct Nutritional Intake in the Prevention and Treatment of Skin Lesions in Patients With Spinal Cord Injury

Abstract

Background: Pressure injuries (PIs) are a serious and highly prevalent complication in individuals with spinal cord injury (SCI), negatively impacting quality of life, rehabilitation, and healthcare costs. Given their multifactorial etiology, a multidisciplinary approach that includes nutritional interventions is essential. This review provides expert consensus on the role of nutrition in PI prevention and management in SCI patients.

Methods: A panel of clinicians, including experts in wound care, nutrition, urology, internal medicine, and rehabilitation, assessed current practices and proposed evidence-based dietary recommendations. A narrative literature review supported the consensus process.

Results: PI risk screening through SCI-specific tools (e.g., Braden scale) and shared decision-making were supported. Nutritional recommendations include aligning energy intake to reduced total daily energy expenditure, highly digestable protein rich in essential amino acids, omega-3 fatty acids, and micronutrients, with adequate hydration. Dietary patterns should be anti-inflammatory, rich in fiber, fruits/vegetables, legumes, fish, and fermented foods. Also, they should modulate gut microbiota and reduce advanced glycation end products through food choices and cooking methods. Practical tools, the Food Suitability Map (traffic-light guidance) and food diary, were proposed to support education, adherence, and self-management. Implementation guidance is provided for acute, chronic, community, and readmission/surgical settings.

Conclusions: This review stresses the urgent need for standardized, SCI-specific nutritional protocols and enhanced interdisciplinary collaboration. Nutrition should be integrated into routine PI care to improve patient outcomes and reduce healthcare burden. Future research should explore nutraceuticals, refine existing protocols, assess long-term impacts of dietary strategies, and strengthen implementation in clinical practice.