title: Effect of nutritional supplements on wound healing in home-nursed elderly: a randomized trial.
abstract: OBJECTIVE
  The objective was to determine whether provision of oral nutritional supplements, delivered by community nurses, could improve nutritional status and wound healing in home-nursed elderly.
  
  
  METHODS
  This was a double-blind, randomized trial in 50 elderly patients referred for wound management. Patients received 237 mL/d of 4 or 8 kJ/mL of an oral nutritional supplement for 4 wk. Nutritional status was measured with the Subjective Global Assessment and the Mini-Mental State Examination questionnaire to determine cognitive function and wound characteristics to assess healing. Differences between variables were examined with the Mann-Whitney or Student's t test for comparing two groups, one-way analysis of variance when there was more than two groups, and chi-square analysis for comparing two categorical variables. Associations between variables were examined with Pearson's correlation and regression analysis.
  
  
  RESULTS
  At baseline, 34% subjects were moderately malnourished and 8% were severely malnourished. In both groups, there was significantly greater improvement in Mini-Mental State Examination scores at week 4 (95% confidence interval -2.0 to -0.001, P = 0.04) and a greater decrease in the wound effusion score (95% confidence interval -2.0 to 0.0, P = 0.045). Median length of stay did not differ between groups (P > 0.05).
  
  
  CONCLUSIONS
  Malnutrition is common in elderly patients who are nursed at home for wound management. Provision of energy- and protein-dense oral supplements by community nurses is effective in improving some indices of wound healing and cognitive function in this group. Although further study is needed to determine the effect on length of stay, the nutritional needs of this vulnerable group should not be overlooked.
authors.affiliation: School of Health Sciences, Faculty of Health, The University of Newcastle, Callaghan, New South Wales, Australia. clare.collins@newcastle.edu.au
authors.forename: Clare E
authors.initials: CE
authors.lastname: Collins
authors.forename: Jill
authors.initials: J
authors.lastname: Kershaw
authors.forename: Sonia
authors.initials: S
authors.lastname: Brockington
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015992:Body Mass Index; D003071:Cognition / Q000187:drug effects*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005526:Food, Formulated; D015577:Geriatric Assessment; D005851:Geriatric Nursing; D006699:Home Care Services; D006801:Humans; D008297:Male; D009752:Nutritional Status; D011502:Protein-Energy Malnutrition / Q000150:complications / Q000453:epidemiology* / Q000628:therapy*; D012044:Regression Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*