title: The effectiveness of a specialised oral nutrition supplement on outcomes in patients with chronic wounds: a pragmatic randomised study.
abstract: BACKGROUND
  Nutrition supplements enriched with immune function enhancing nutrients have been developed to aid wound-healing, although evidence regarding their effectiveness is limited and systematic reviews have lead to inconsistent recommendations. The present pragmatic, randomised, prospective open trial evaluated a wound-specific oral nutrition supplement enriched with arginine, vitamin C and zinc compared to a standard supplement with respect to outcomes in patients with chronic wounds in an acute care setting.
  
  
  METHODS
  Twenty-four patients [11 males and 13 females; mean (SD) age: 67.8 (22.3) years] with chronic wounds (14 diabetic or venous ulcers; 10 pressure ulcers or chronic surgical wounds) were randomised to receive either a wound-specific supplement (n = 12) or standard supplement (n = 12) for 4 weeks, with ongoing best wound and nutrition care for an additional 4 weeks. At baseline, and at 4 and 8 weeks, the rate of wound-healing, nutritional status, protein and energy intake, quality of life and product satisfaction were measured. Linear mixed effects modelling with random intercepts and slopes were fitted to determine whether the wound-specific nutritional supplement had any effect.
  
  
  RESULTS
  There was a significant improvement in wound-healing in patients receiving the standard nutrition supplement compared to a wound-specific supplement (P = 0.044), although there was no effect on nutritional status, dietary intake, quality of life and patient satisfaction.
  
  
  CONCLUSIONS
  The results of the present study indicate that a standard oral nutrition supplement may be more effective at wound-healing than a specialised wound supplement in this clinical setting.
authors.affiliation: Centre for Dietetic Studies (C-DIET-R), School of Human Movement Studies, University of Queensland, Brisbane, Queensland, Australia; The Wesley Hospital, Brisbane, Queensland, Australia.
authors.forename: J D
authors.initials: JD
authors.lastname: Bauer
authors.forename: E
authors.initials: E
authors.lastname: Isenring
authors.forename: M
authors.initials: M
authors.lastname: Waterhouse
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D001205:Ascorbic Acid / Q000008:administration & dosage; D002908:Chronic Disease; D004044:Dietary Proteins / Q000008:administration & dosage; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy / Q000379:methods; D009752:Nutritional Status; D003668:Pressure Ulcer / Q000178:diet therapy* / Q000473:pathology; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*; D015032:Zinc / Q000008:administration & dosage
chemical_list: D004044:Dietary Proteins; D015032:Zinc; D001205:Ascorbic Acid
keywords: nutrition counselling; nutrition supplements; nutrition support; outcomes; wounds