Nutrition is essential for patients, affecting the quality of care and treatment in general. Many studies have shown that patients have nutritional problems (at risk of malnutrition or severe malnutrition) which range between 20 to 50% [7,9,10]. Malnutrition, especially undernutrition causes postoperative complications, prolonged hospital stay, and increases treatment costs. Despite the interest and advances in interventions, the undernutrition of patients is still not fully concerned. For surgical or trauma patients, nutrition plays an even more important role. Undernutrition increases the risk of postoperative complications such as surgical site infection, anastomotic leaks, delayed wound healing, etc. Besides, undernutrition is also associated with other nosocomial infections such as pneumonia, sepsis. Trauma patients with undernutrition are not being except with complications and mortality, prolonged hospital stay. In the studies conducted by Xin Chen in China in a large number of trauma patients in the plastic surgery department of Xinqiao Hospital, Chongqing [10], by Nguyen Tien Dung of the National Institute of Burns [4] in patients with wounds have shown the role of nutrition in wound healing. In the report of NV Pham [11] and colleagues on 438 surgical patients at some hospitals in the Mekong Delta region of Vietnam, the malnourished group had a higher rate of complications than the group without malnutrition problems, especially postoperative infectious complications.

According to dietetic experts, nutrients enhance the ability to rebuild connective tissue, promoting wound healing. Wound healing is a complicated process through three stages: Inflammatory phase - Proliferative phase - Remodelling phase, protein deficiency prolongs the inflammatory phase because protein contains nitrogen, stores amino acids, plays an important role in tissue reconstruction [12,13,14,15].

The causes of undernutrition are divided into 3 groups [14,15]:

Decreased nutrient tolerance due to anorexia: elderly, psychological, pathological patients; Decreased ability to digest and absorb: mainly related to gastrointestinal diseases such as short bowel, intestinal tuberculosis, cancer, sub-obstruction, drug side effects, after surgery ... Loss of nutrients: gastrointestinal fistula, burns, injury…

Increase metabolism due to trauma, burns, surgery

Administered ways: oral (enteral) or intravenous (parenteral).

It can be said that undernutrition has many combined causes, especially for trauma patients, the result of an imbalance between nutrient supply and nutrient consumption over a while, causing functional impairment body.

To improve nutritional status which helps to treatment outcomes, and to prevent the risk of complications, patients should be evaluated for nutritional status as soon as they are admitted to the hospital for adjustment nutrition regimen, it includes:

Rapid assessment of overall nutritional status: based on anthropometry such as BMI (Body Mass Index), NRS-2002 (Nutrition Risk Screening-2002), subjective nutritional assessment (SGA).

Assessment of adipose muscle and tests: Determination of body composition through muscle mass, fat by clinical or ultrasound check or muscle strength by assessment of hand force, biochemical tests by serum albumin/prealbumin levels. [16,17,18]

In which, the risk of undernutrition is assessed through easy-to-implement and valuable laboratory indicators, which is the measurement of serum prealbumin (transthyretin). It is a tryptophan-rich protein and, similar to albumin, it is synthesized in the hepatocytes of the liver and released in the blood [8,18]. It helps to carry certain hormones that regulate how the body uses energy and other substances through blood circulation. When prealbumin levels are lower than normal, it might be a sign of undernutrition and doctors will adjust protein supplements or fluids accordingly. For trauma and injured patients, assessment by weight, squeeze force, and fat muscle mass cannot be done because of many soft tissues already damaged and the patients should be immobilized on beds, therefore based on biochemical tests, it will be an easy way to perform. According to Albina JE (1994) [8], blood tests for albumin and prealbumin are also a way to assess nutrition for hospitalized patients when other measures are not possible to conduct. On the other hand, these two test indicators are also used to evaluate the effectiveness of post nutritional intervention for patients. Although no method of assessment is perfect, the application of the assessment of malnutrition will provide appropriate intervention and assist the physician in the wound care process. Besides, because the length of stay of trauma patients is not as long as the patients with chronic wounds, the assessment needs to be early and timely. The prealbumin's short half-life of 2 days, is suitable for evaluation.

Prealbumin is a misnomer; the correct name is transthyretin [3]. As it has a short half-life (2 days) and a relatively small pool, it might be a better indicator to assess nutritional status than the widely used albumin serum level [4].

In our series, males accounted for the vast majority of patients with 81.4%, females accounted for only 18.6% (Figure 1), most of the trauma patients were young and the average age was 37.1 ± 2.3, which related to traffic accidents accounted for the majority of 84% (Figure 2). The location of injury in the lower limb accounts for 78.6%, the upper limb is 15.7%, only 5.7% affects other parts of the body (Table 1). In our series, the characteristics of wounds were in Table 2 shown that complex wounds accounted for 78.6%, sized more than 10cm for 58.6%, and over 15cm was 10%. Risk factors were exudate for 75.3%.

Table 3 relates to co-morbidities diseases, the combined causes of delayed healing. This is similar to other reports showing that healing factors are strongly influenced by co-morbidities diseases such as Mellitus diabetes and cardiovascular disease [4,9,10,19].