One of the National Health Events for the month of March is Burn Injury Prevention Month. In medicine, a burn is a type of injury to the skin caused by heat, electricity, chemicals, or radiation (an example of the latter is sunburn). Serious burns, especially if they cover large areas of the body, can cause death.

As a nutritionist, I leave the medical treatment to the doctors and give in-depth attention to the nutritional needs of a burn patient. The first important part of nutritional provision is adequate fluid. Fluid requirement is determined by using the formula:

thus, if the patient has a TBSA of 18 percent (meaning, burn area covers one leg) and weighs 50 kilos, his daily fluid needs is 3600 ml. As much as 20 percent of body protein may be lost within two weeks in cases of severe burn, thus, this condition is considered highly catabolic.

Early and aggressive nutritional support is necessary to minimize the loss of body proteins and improve metabolic and immune response, reduce infectious complication and support wound healing. When total body surface area (TBSA) burned is less than 20 percent, nutritional needs are usually met with oral diet alone, but above 20 percent TBSA, powdered nutritional supplements may be necessary to meet the body’s increased demands.

As appetite may be poor, easily digestible foods should be available, those which are mechanically soft, without skin, seeds and stems, and not too oily. In trying to meet the person’s needs for calorie (which could be 50 percent higher than his usual requirements), provide calorie-dense foods but those that does not necessarily promote satiety. Protein and amino acid requirements increase to support formation of new tissues and proliferation of immune cells, maintain lean body mass (or muscle protein), and replace the protein lost to perspiration, and excretion.

During trauma, proteins, including muscle mass, are broken down to yield as much as 30 percent of caloric needs. Even when nutrients are supplemented, proteins will be utilized to provide 20 percent to 25 percent of daily caloric needs. Even when the patient is well fed, it is critical that trauma patients maintain an adequate supply of protein and calories to protect their lean muscle mass and supply their healing body with necessary nutrients. This macronutrients (carbohydrates and protein) must adequately be met to prevent on-set of protein –calorie malnutrition because if this happens, the malnourished patient can quickly exhibit symptoms of decreased immune function, such as infection.

For Burn patients, micronutrients are as important as the macronutrients, and these are Vitamins A, C, E, Zinc, Glutamine, Glucosamine and Arginine. Sources of these foods include:

Vitamin A rich foods – sweet potatoes, carrots, mangoes, spinach, cantaloupe, dried apricots, milk, egg yolks and mozzarella cheese

Vitamin C rich foods – sweet potatoes, vine-ripened tomatoes, collard greens, kale, brussel sprouts, red cabbage, snow peas and broccoli, freshly squeezed orange

Vitamin E rich foods – most vegetable oils, margarine, most nuts and green leafy vegetables

Food sources of zinc – beef, pork, lamb, dark meat of chicken, peanut, peanut butter and legumes

Food Sources of Glutamine – meat, fish and dairy products

Sources of Glucosamine – no food sources but only from supplements

Source or Arginine – Pro-Argi9 food supplement, dairy, meat, poultry, fish, nuts and chocolate

To experience the mildest degree of burn is excruciating to some people, but to all having acquired severe burn is damaging not only to their skin but also to their moral. The soonest time that their skin heal, the better for the person to feel well, immediately. Good nutrition is very important in healing burned skin, do not take risk of prolonging the healing process.