title: 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 <or= 0.016, RMMM). The decrease in severity score (Pressure Ulcer Scale for Healing) in the supplemented group differed significantly (P <or= 0.033, RMMM) from the control. Moreover, significantly fewer dressings were required per week in the ONS group compared with the control (P <or= 0.045, RMMM) and less time was spent per week on changing the dressings (P <or= 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Nutricia Advanced Medical Nutrition, Danone Research, Centre for Specialised Nutrition, Wageningen, The Netherlands. rogier.vananholt@nutricia.com
authors.forename: R D
authors.initials: RD
authors.lastname: van Anholt
authors.forename: L
authors.initials: L
authors.lastname: Sobotka
authors.forename: E P
authors.initials: EP
authors.lastname: Meijer
authors.forename: H
authors.initials: H
authors.lastname: Heyman
authors.forename: H W
authors.initials: HW
authors.lastname: Groen
authors.forename: E
authors.initials: E
authors.lastname: Topinková
authors.forename: M
authors.initials: M
authors.lastname: van Leen
authors.forename: J M G A
authors.initials: JM
authors.lastname: Schols
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001120:Arginine / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000097:blood; D001458:Bandages; D004044:Dietary Proteins / Q000008:administration & dosage*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000627:therapeutic use*; D015233:Models, Statistical; D009752:Nutritional Status; D003668:Pressure Ulcer / Q000178:diet therapy* / Q000473:pathology; D012016:Reference Values; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology*; D014945:Wound Healing
chemical_list: D004044:Dietary Proteins; D018977:Micronutrients; D001120:Arginine; D001205:Ascorbic Acid