Specific Nutritional Support Accelerates Pressure Ulcer Healing and Reduces Wound Care Intensity in Non-Malnourished Patients

Nutrition. 2010 Sep; 26(9):867-72. doi: 10.1016/j.nut.2010.05.009. Epub 2010 Jul 3.
van Anholt, R. D., Sobotka, L., Meijer, E. P., Heyman, H., Groen, H. W., Topinková, E., van Leen, M., & Schols, J. M.


Objective: We investigated the potential of a high-protein, arginine- and micronutrient-enriched oral nutritional supplement (ONS) to improve healing of pressure ulcers in non-malnourished patients who would usually not be considered for extra nutritional support.

Methods: Forty-three non-malnourished subjects with stage III or IV pressure ulcers were included in a multicountry, randomized, controlled, double-blind, parallel group trial. They were offered 200 mL of the specific ONS or a non-caloric control product three times per day, in addition to their regular diet and standard wound care, for a maximum of 8 wk. Results were compared with repeated-measures mixed models (RMMM), analysis of variance, or Fisher's exact tests for categorical parameters.

Results: Supplementation with the specific ONS accelerated pressure ulcer healing, indicated by a significantly different decrease in ulcer size compared with the control, over the period of 8 wk (P <or= 0.016, RMMM). The decrease in severity score (Pressure Ulcer Scale for Healing) in the supplemented group differed significantly (P <or= 0.033, RMMM) from the control. Moreover, significantly fewer dressings were required per week in the ONS group compared with the control (P <or= 0.045, RMMM) and less time was spent per week on changing the dressings (P <or= 0.022, RMMM). At the end of the study, blood vitamin C levels had significantly increased in the ONS group compared with the control (P = 0.015, analysis of variance).

Conclusion: Specific nutritional supplementation accelerated healing of pressure ulcers and decreased wound care intensity in non-malnourished patients, which is likely to decrease overall costs of pressure ulcer treatment.

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List of abbreviations

DGEM German Society for Nutritional Medicine (German Deutsche Gesellschaft für Ernährungsmedizin)
GESKES  Swiss Society for Clinical Nutrition (German Gesellschaft für klinische Ernährung der Schweiz) 
ESPEN European Society of Clinicl Nutrition and Metabolism