The effectiveness of a specialised oral nutrition supplement on outcomes in patients with chronic wounds: a pragmatic randomised study

Abstract

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.

Effects of an Arginine-Enriched Oral Nutritional Supplement on the Healing of Chronic Wounds in Non-Malnourished Patients; A Multicenter Case Series from the Netherlands and Hungary

“…In contrast, the findings of two studies were not in line with the findings of these studies [31,32]. A pragmatic randomised trial showed a significant improvement in wound healing in patients receiving standard nutrition supplement compared to wound-specific supplement, although there was a clinically relevant improvement in quality of life and patient satisfaction in the wound-specific ONS group [31]. The other study, a placebo-controlled randomised controlled trial (RCT), showed that the use of specialised amino acids did not appear to reduce PU wound size [32].…”

“…These findings are in line with clinical studies showing a positive effect of nutritional supplementation with additional protein, arginine and micronutrients to promote PU healing [17,18,[22][23][24][25][26][27][28][29][30]. In contrast, the findings of two studies were not in line with the findings of these studies [31,32]. A pragmatic randomised trial showed a significant improvement in wound healing in patients receiving standard nutrition supplement compared to wound-specific supplement, although there was a clinically relevant improvement in quality of life and patient satisfaction in the wound-specific ONS group [31].…”

Escarres : comment accélérer la cicatrisation ?

“…Il reste à montrer qu'à apports énergétiques et protéiques égaux, des malades supplémentés en arginine et/ou micronutriments cicatrisent leurs escarres plus rapidement. Curieusement, une étude plus récente de 2013, avec un petit effectif de sujet inclus, comparant CNO enrichi versus standard, donne l'avantage au CNO standard en termes de PUSH score [26]. Une étude tout récemment publiée montre que chez 200 patients âgés de 81 ans en moyenne, vivant en service de longue durée ou bénéfi-ciant d'aides à domicile, dénutris et porteurs d'une ou plusieurs escarres, les CNO enrichis en arginine et micronutriments ont permis d'accélérer la cicatrisation de l'escarre, avec un pourcentage de réduction de la surface de l'escarre significativement plus important que chez les patients ayant des apports éner-gétiques et protéiques comparables avec des CNO standards [27].…”

Economic Evaluation of Nutrition Support in the Prevention and Treatment of Pressure Ulcers in Acute and Chronic Care Settings: A Systematic Review

“…Earlier reviews showed that high protein supplementation may reduce the risk for PU development or heal PU, but with mixed outcomes when specialized nutrition supplement was used . Recent studies have also demonstrated the potential of using supplementation with specific nutrients such as arginine, β‐hydroxy β‐methylbutyrate, zinc, and antioxidants in treating PU …”

“…11,12 Recent studies have also demonstrated the potential of using supplementation with specific nutrients such as arginine, β-hydroxy β-methylbutyrate, zinc, and antioxidants in treating PU. [13][14][15][16][17][18][19] In view of these recent developments in nutrition intervention for PU prevention and treatment, it is important to assess whether such interventions are also cost-effective. The primary aims of this systematic review are to determine the total cost and cost-effectiveness of nutrition support in PU prevention and treatment, and the secondary aims to determine the associated clinical outcomes such as wound healing rates, length of hospital stay, survival time, and quality of life.…”