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Nutritional interventions for preventing and treating pressure ulcers.

Gero Langer1, Astrid Fink

  • 1Institute of Health and Nursing Sciences, German Center for Evidence-based Nursing, Martin Luther University Halle-Wittenberg, Magdeburger Strasse 8, Halle (Saale), Germany, 06112.

The Cochrane Database of Systematic Reviews
|June 13, 2014
PubMed
Summary

Nutritional interventions show no clear benefit for preventing or treating pressure ulcers. More high-quality trials are needed to confirm any potential effects of nutritional support on pressure ulcer development and healing.

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Area of Science:

  • Clinical Nutrition
  • Wound Care
  • Geriatric Medicine

Background:

  • Pressure ulcers affect 10% of hospitalized patients, with older adults at highest risk.
  • Inadequate nutritional intake is a suspected factor in pressure ulcer development, but evidence is inconsistent.

Purpose of the Study:

  • To evaluate the efficacy of enteral and parenteral nutrition in preventing and treating pressure ulcers.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted.
  • Searches included multiple databases (Cochrane, Medline, Embase, CINAHL) with no date or language restrictions.
  • Data extraction and risk of bias assessment were performed independently by two reviewers.

Main Results:

  • Eleven trials on prevention found no clear evidence that nutritional supplements reduce pressure ulcer incidence (RR 0.86; 95% CI 0.73 to 1.00).
  • Fourteen trials on healing showed no clear benefit from various nutritional supplements (mixed supplements, protein, zinc, ascorbic acid).
  • Included RCTs were often small and at high risk of bias, with significant heterogeneity.

Conclusions:

  • Current evidence does not support the use of nutritional interventions for pressure ulcer prevention or treatment.
  • Further high-quality randomized controlled trials are required to establish the role of nutrition in pressure ulcer management.