Cereda E, Neyens JCL, Caccialanza R, Rondanelli M, Schols JMGA, et al.
The journal of nutrition, health & aging. Date of publication 2017 Jan 1;volume 21(6):655-661.
1. J Nutr Health Aging. 2017;21(6):655-661. doi: 10.1007/s12603-016-0822-y.
Efficacy of a Disease-Specific Nutritional Support for Pressure Ulcer Healing: A
Systematic Review and Meta-Analysis.
Cereda E(1), Neyens JCL, Caccialanza R, Rondanelli M, Schols JMGA.
Author information:
(1)Emanuele Cereda MD, PhD, Servizio di Dietetica e Nutrizione Clinica,
Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy,
Tel.: +39 0382 501615 ; Fax: + 39 0382 502801, E-mail: e.cereda@smatteo.pv.it.
OBJECTIVES: The aim of this systematic review was to summarize the evidence on
the efficacy of high-calorie, high-protein nutritional formula enriched with
arginine, zinc, and antioxidants (disease-specific support) in patients with
pressure ulcers (PUs).
METHODS: Randomized controlled trials in English published from January 1997
until October 2015 were searched for in electronic databases (EMBASE, Medline,
PubMed, and CINAHL). Studies comparing a disease-specific nutritional support
(oral supplements or tube feeding) to a control nutritional intervention enabling
the satisfaction of energy requirements regardless of the use of high-calorie
formula or placebo or no support for at least 4 weeks were considered eligible.
Study outcomes were the percentage of change in PU area, complete healing and
reduction in the PU area ≥40% at 8 weeks, and the percentage of change in area at
4 weeks.
RESULTS: A total of 3 studies could be included in the meta-analysis. Compared
with control interventions, formulas enriched with arginine, zinc and
antioxidants resulted in significantly higher reduction in ulcer area (-15.7%
[95%CI, -29.9, -1.5]; P=0.030; I2=58.6%) and a higher proportion of participants
having a 40% or greater reduction in PU size (OR=1.72 [95%CI, 1.04, 2.84];
P=0.033; I2=0.0%) at 8 weeks. A nearly significant difference in complete healing
at 8 weeks (OR=1.72 [95%CI, 0.86, 3.45]; P=0.127; I2=0.0%) and the percentage of
change in the area at 4 weeks (-7.1% [95%CI, -17.4, 3.3]; P=0.180; I2=0.0%) was
also observed.
CONCLUSIONS: This systematic review shows that the use of formulas enriched with
arginine, zinc and antioxidants as oral supplements and tube feeds for at least 8
weeks are associated with improved PU healing compared with standard formulas.
DOI: 10.1007/s12603-016-0822-y
PMID: 28537329 [Indexed for MEDLINE]
Conflict of interest statement: The Authors certify that there are no
affiliations with, or involvement in, any organization or entity that has a
direct financial interest in the subject matter, or material, discussed in the
manuscript. Dr. Cereda reports having received (not for the present study and
before 2010) consultancy and speaker honoraria and investigator grants from the
“Fondazione Grigioni per il Morbo di Parkinson”, the Fondazione IRCCS Policlinico
San Matteo and Nutricia Italia
