Efficacy of a Disease-Specific Nutritional Support for Pressure Ulcer Healing: A Systematic Review and Meta-Analysis

E. Cereda, J. C. L. Neyens, R. Caccialanza, M. Rondanelli, J. M. G. A. Schols

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: The aim of this systematic review was to summarize the evidence on the efficacy of high-calorie, high-protein nutritional formula enriched with arginine, zinc, and antioxidants (disease-specific support) in patients with pressure ulcers (PUs). METHODS: Randomized controlled trials in English published from January 1997 until October 2015 were searched for in electronic databases (EMBASE, Medline, PubMed, and CINAHL). Studies comparing a disease-specific nutritional support (oral supplements or tube feeding) to a control nutritional intervention enabling the satisfaction of energy requirements regardless of the use of high-calorie formula or placebo or no support for at least 4 weeks were considered eligible. Study outcomes were the percentage of change in PU area, complete healing and reduction in the PU area >/=40% at 8 weeks, and the percentage of change in area at 4 weeks. RESULTS: A total of 3 studies could be included in the meta-analysis. Compared with control interventions, formulas enriched with arginine, zinc and antioxidants resulted in significantly higher reduction in ulcer area (-15.7% [95%CI, -29.9, -1.5]; P=0.030; I2=58.6%) and a higher proportion of participants having a 40% or greater reduction in PU size (OR=1.72 [95%CI, 1.04, 2.84]; P=0.033; I2=0.0%) at 8 weeks. A nearly significant difference in complete healing at 8 weeks (OR=1.72 [95%CI, 0.86, 3.45]; P=0.127; I2=0.0%) and the percentage of change in the area at 4 weeks (-7.1% [95%CI, -17.4, 3.3]; P=0.180; I2=0.0%) was also observed. CONCLUSIONS: This systematic review shows that the use of formulas enriched with arginine, zinc and antioxidants as oral supplements and tube feeds for at least 8 weeks are associated with improved PU healing compared with standard formulas.
Original languageEnglish
Pages (from-to)655-661
Number of pages7
JournalJournal of Nutrition, Health and Aging
Volume21
Issue number6
DOIs
Publication statusPublished - 2017

Keywords

  • Antioxidants/therapeutic use
  • Arginine/therapeutic use
  • Dietary Supplements
  • Energy Intake
  • Enteral Nutrition
  • Humans
  • Nutritional Support
  • Outcome Assessment (Health Care)
  • Pressure Ulcer/therapy
  • Wound Healing/drug effects
  • Zinc/therapeutic use
  • Pressure ulcers
  • arginine
  • healing
  • malnutrition

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