Efficacy of a Disease-Specific Nutritional Support for Pressure Ulcer Healing: A Systemic Review and Meta-Analysis
Cereda E, Neyens JCL, Caccialanza R, Rondanelli M & Schols JMGA.
Journal of Nutrition Health and Aging 2017; 21(6): 665-661.
Objective:
To meta-analyze results on the efficacy of using high-calorie, high protein nutritional formula (oral or enteral) enriched with arginine, zinc and antioxidants in patients with pressure ulcers.
Methods:
Meta-analysis included three multi-center randomized controlled trials of elderly long-term care and home care patients (n=273) comparing specialized and control nutritional support in moderate to severe pressure injury (Stages 2, 3 & 4). The primary outcome of interest was the percentage change in pressure ulcer area at 8 weeks. Secondary outcomes included reduction in wound area of ≥40% and complete healing at 8 weeks, and percentage change in area at 4 weeks.
Results:
Compared with controls, providing additional amounts of L-arginine, zinc and other antioxidants (Cu, vitamins C & E, Se, Mn) as part of a specialized energy dense and protein rich ONS or TF (1.25 kcal/mL; 20% protein) was found to:
• Reduce pressure ulcer area to a greater extent (–15.7% [95%CI, –29.9, –1.5]; p=0.03)
• Reduce pressure ulcer size by ≥40% in more participants at 8 weeks (OR=1.72 [95%CI, 1.04, 2.84]; p=0.033)
Conclusion:
Specialized ONS and enteral formulas used for at least 8 weeks are associated with better healing of Stage 2, 3 & 4 pressure injuries than standard interventions.
1. Cereda E et al. Ann Intern Med 2015;162: 167-174.
2. van Anholt RD et al. Nutr 2010; 26: 867-872.
3. Cereda E et al. J Am Geriatr Soc 2009; 57: 1395-1402
Summary prepared by Nestlé Health Science. Download PDF of Summary
The complete study may be accessed online: https://pubmed.ncbi.nlm.nih.gov/28537329/
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