Malnutrition is known to be prevalent among patients with pressure ulcers, and is considered a factor contributing to the development of, as well as inhibiting the healing of these ulcers. As previous studies have demonstrated that supplementation with nutritional formulas enriched with arginine, zinc and antioxidants may having a healing effect, this study further investigated whether an oral nutritional supplement enriched with those substances can assist in healing pressure ulcers.
METHODSSubjects were long-term care residents or homecare patients with stage II through stage IV pressure ulcers, all demonstrating malnourishment, defined as a low body mass index, recent unintentional weight loss, low serum albumin levels and reduced food intake. The subjects were randomized to receive a control formula or an experimental formula enriched with arginine, zinc, and vitamins E and C. All patients received optimal wound care. Pressure ulcer areas were documented at baseline, and four and eight weeks.
RESULTSOf the screened patients, 200 were randomized. Both groups realized improved wound healing. Compared to baseline, pressure ulcer areas were decreased by an average of 60.9% in the treatment group and 45.2% in the control group (P=0.017). In the treatment group, 16.9% experienced complete healing, as compared with 9.7% in the control group (P=0.097). Withdrawals from the study included two in the experimental group and three in the control group, with gastrointestinal intolerance as the primary cause of withdrawal.
CONCLUSIONThis study found that, when added to optimal wound care and proper nutrition, a formula with arginine, zinc and antioxidants seems to accelerate pressure ulcer wound healing.