The importance of dietary protein in healing pressure ulcers.
OBJECTIVE
To determine the effect of dietary protein on healing of pressure ulcers in malnourished patients.


METHODS
Nutritional intervention trial with the non-randomized assignment of patients by pressure ulcer stage and bed type.


METHODS
Long-term care facility.


METHODS
Twenty-eight malnourished patients (age = 72 +/- 18 years, mean +/- SD) with a total of 33 truncal pressure ulcers. Nine patients had stage II ulcers, eight had stage III ulcers, and 16 had stage IV ulcers.


METHODS
Patients received liquid nutritional formulas as tubefeedings or meal supplements containing either 24% protein (61 g protein/L; n = 15) or 14% protein (37 g protein/L; n = 13) for 8 weeks.


RESULTS
There was a significant decrease in total truncal pressure ulcer surface area of the 15 patients in the 24% protein group (-4.2 +/- 7.1 cm2, P < 0.02), but not in the 13 patients in the 14% protein group (-2.1 +/- 11.5 cm2, P = NS). The change in total ulcer area correlated with both dietary protein intake per kg body weight (rs = -0.50, P < 0.01) and caloric intake per kg body weight (rs = -0.41, P < 0.03). The decrease in stage IV ulcer area in eight patients in the 24% protein group (-7.6 +/- 5.8 cm2, P < 0.02) was significantly greater (P < 0.05) than in eight patients in the 14% protein group (-3.2 +/- 16.4, P = NS). In these 16 patients, the decrease in ulcer size also correlated with dietary protein intake per kg body weight (rs = -0.63, P < 0.01).


CONCLUSIONS
High protein diets may improve the healing of pressure ulcers in malnourished nursing home patients.
Breslow
R A
RA
Department of Human Nutrition and Food Systems, University of Maryland, College Park.
Hallfrisch
J
J
Guy
D G
DG
Crawley
B
B
Goldberg
A P
AP
D000368:Aged; D015142:Baltimore / Q000453:epidemiology; D001830:Body Surface Area; D001835:Body Weight; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D004750:Enteral Nutrition / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D009752:Nutritional Status; D003668:Pressure Ulcer / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D011502:Protein-Energy Malnutrition / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D012307:Risk Factors; D014945:Wound Healing
D004044:Dietary Proteins