[Effects of nutrition intervention for pressure ulcer patients--healing rate and speed of wound size and nutrition--].

UNLABELLED: The objective of this multicenter open-label randomized study was for evaluating nutrition intervention on pressure ulcer healing. Tube-fed patients with Stages III to IV pressure ulcers were enrolled. Target energy levels to be given were the same value as at the time of enrollment or BEE×1.1 (activity factor)×1.1-1.3 (stress factor) in the control group, and BEE×1.1×1.3-1.5 in the intervention group. Both groups received the feeding formula Racol(®) for 12 weeks, and were prescribed to have pressure relief mattresses, and to unify the repositioning method, treatment drugs, and wound dressing materials. Ulcer sizes (length×width), nutritional state, and adverse events were evaluated. RESULTS OF THE STUDY: Energy levels administered to the control (n=29) and intervention (n=21) groups were 29.1±4.9 (mean±SD) and 37.9±6.5 kcal/kg/day, respectively. Regarding pressure ulcer size, the interaction between the nutrition intervention and the courses during observational weeks was significant (P<0.001). Similarly, significant differences were observed with weight, waist circumference, Cu (P<0.001), suprailiac skinfold thickness (P<0.01), thigh circumference, and prealbumin (P<0.05), but not with the incidence of adverse events (P=0.360). Principal component analysis indicated remarkable decreases in ulcer size and improvement rates of waist circumference and suprailiac skinfold thickness in the intervention group. Covariance structure analysis showed that nutrition intervention has a direct effect on reduction in ulcer size. The results suggested that aggressive nutrient intervention accelerated the pressure ulcer of wound healing process and had a direct effect on reduction in ulcer size.

Evaluation of effects of nutrition intervention on healing of pressure ulcers and nutritional states (randomized controlled trial).

The objective of this study was to evaluate the effects of nutrition intervention on nutritional states and healing of pressure ulcers by standardizing or unified factors including nursing, care and treatment in a multicenter open randomized trial. Tube-fed patients with Stage III-IV pressure ulcers were selected. The control group (30 patients) received the same nutrition management as before participating in this trial, whereas the intervention group (30 patients) was given calories in the range of Basal Energy Expenditure (BEE) × 1.1 × 1.3 to 1.5. The intervention period was 12 weeks. The efficacy and safety were evaluated based on the nutritional states and the sizes of ulcers (length × width), and on the incidence of adverse events related to the study, respectively. The calories administered to the control and intervention groups were 29.1 ± 4.9 and 37.9 ± 6.5 kcal/kg/day, respectively. Significant interactions between the presence or absence of the intervention and the intervention period were noted for nutritional states (p<0.001 for body weight, p<0.05 for prealbumin). Similarly, the size of ulcers differed significantly between subjects in the intervention group and in the control group (p<0.001). The results suggest that nutrition intervention could directly enhance the healing process in pressure ulcer patients.