Specific nutritional support accelerates pressure ulcer healing and reduces wound care intensity in non-malnourished patients

Abstract 

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 ≤ 0.016, RMMM). The decrease in severity score (Pressure Ulcer Scale for Healing) in the supplemented group differed significantly (P ≤ 0.033, RMMM) from the control. Moreover, significantly fewer dressings were required per week in the ONS group compared with the control (P ≤ 0.045, RMMM) and less time was spent per week on changing the dressings (P ≤ 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.

Keywords: Pressure ulcers, Oral nutritional supplement, Non-malnourished, Protein, Arginine, Zinc, Vitamins