title: A nutritional formula enriched with arginine, zinc, and antioxidants for the healing of pressure ulcers: a randomized trial.
abstract: BACKGROUND
  Trials on specific nutritional supplements for the treatment of pressure ulcers (PUs) have been small, inconsistent in their formulations, or unsuccessful in controlling for total supplement calorie or protein content.
  
  
  OBJECTIVE
  To evaluate whether supplementation with arginine, zinc, and antioxidants within a high-calorie, high-protein formula improves PU healing.
  
  
  METHODS
  Multicenter, randomized, controlled, blinded trial. (ClinicalTrials.gov: NCT01107197).
  
  
  METHODS
  Long-term care and home care services.
  
  
  METHODS
  200 adult malnourished patients with stage II, III, and IV PUs.
  
  
  METHODS
  An energy-dense, protein-rich oral formula enriched with arginine, zinc, and antioxidants (400 mL/d) or an equal volume of an isocaloric, isonitrogenous formula for 8 weeks.
  
  
  METHODS
  The primary end point was the percentage of change in PU area at 8 weeks. Secondary end points included complete healing, reduction in the PU area of 40% or greater, incidence of wound infections, the total number of dressings at 8 weeks, and the percentage of change in area at 4 weeks.
  
  
  RESULTS
  Supplementation with the enriched formula (n = 101) resulted in a greater reduction in PU area (mean reduction, 60.9% [95% CI, 54.3% to 67.5%]) than with the control formula (n = 99) (45.2% [CI, 38.4% to 52.0%]) (adjusted mean difference, 18.7% [CI, 5.7% to 31.8%]; P = 0.017). A more frequent reduction in area of 40% or greater at 8 weeks was also seen (odds ratio, 1.98 [CI, 1.12 to 3.48]; P = 0.018). No difference was found in terms of the other secondary end points.
  
  
  CONCLUSIONS
  Participation was restricted to patients who were malnourished, were able to drink oral supplements, and were living in long-term care institutions or receiving home care services.
  
  
  CONCLUSIONS
  Among malnourished patients with PU, 8 weeks of supplementation with an oral nutritional formula enriched with arginine, zinc, and antioxidants improved PU healing.
  
  
  BACKGROUND
  Azienda Ospedaliera Universitaria Maggiore della Carità.
authors: Emanuele
authors: E
authors: Cereda
authors: Catherine
authors: C
authors: Klersy
authors: Marcella
authors: M
authors: Serioli
authors: Aldo
authors: A
authors: Crespi
authors: Federico
authors: F
authors: D'Andrea
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000627:therapeutic use*; D001120:Arginine / Q000627:therapeutic use*; D002423:Cause of Death; D004311:Double-Blind Method; D005260:Female; D005526:Food, Formulated / Q000009:adverse effects; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006760:Hospitalization; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000628:therapy*; D003668:Pressure Ulcer / Q000150:complications / Q000628:therapy*; D014131:Trace Elements / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing; D015032:Zinc / Q000627:therapeutic use*
chemical_list: D000975:Antioxidants; D014131:Trace Elements; D001120:Arginine; D015032:Zinc