Heyman H, Van De Looverbosch D E J, Meijer E P, Schols J M G A
OCMW Nursing Homes, Antwerp, Belgium.
J Wound Care. 2008 Nov;17(11):476-8, 480. doi: 10.12968/jowc.2008.17.11.31475.
To investigate the effects of an oral nutritional supplement (ONS) plus standard care on the healing of pressure ulcers in long-term nursing home residents in addition to standard care. The ONS (Cubitan, Nutricia Advanced Medical Nutrition) was high in energy and protein, and enriched with arginine, vitamin C and zinc.
A total of 245 patients with grade II-IV pressure ulcers were enrolled into this open study at 61 long-term-care facilities, which reflect the nursing-home population of Luxembourg and Belgium. Residents received the ONS daily for nine weeks, along with their normal diet or enteral feed and standard pressure care. Pressure ulcer area (mm2) and condition were assessed after three and nine weeks. Data were analysed using ANOVA and expressed as mean +/- SD.
The patients' age was 82.2 +/- 10.1 years. Sixty-seven patients (27%) had been previously treated with the ONS. The majority of pressure ulcers were located at the sacrum (54%) and heel (32%). The average intake of the 200 ml ONS was 2.3 +/- 0.56 servings daily, which corresponds to 46 g protein, 6.9 g arginine, 575 mg vitamin C, 87 mg vitamin E and 21 mg zinc. After nine weeks' nutritional support, the average pressure ulcer area reduced significantly from 1580 +/- 3743 mm2 to 743 +/- 1809 mm2, which is a reduction of 53% (p<0.0001). Complete wound closure occurred after three and nine weeks in 7% and 20% of the pressure ulcers respectively. The amount of exudation (assessed subjectively) also decreased after specialised nutritional support (p<0.0001).
A high-protein ONS enriched with arginine, vitamin C, vitamin E and zinc, when used with standard pressure ulcer care, significantly reduced the mean pressure ulcer area of long-term nursing home residents.
研究口服营养补充剂（ONS）联合标准护理对长期居住在养老院居民压疮愈合的影响，对照仅采用标准护理的情况。该ONS（Cubitan，纽迪希亚先进医学营养公司生产）能量和蛋白质含量高，并富含精氨酸、维生素C和锌。
共有245例II-IV级压疮患者在卢森堡和比利时的61家长期护理机构参与了这项开放性研究，这些机构代表了卢森堡和比利时养老院人群。患者在接受正常饮食或肠内营养以及标准压疮护理的同时，每天服用ONS，持续9周。在3周和9周后评估压疮面积（平方毫米）和状况。数据采用方差分析进行分析，并以平均值±标准差表示。
患者年龄为82.2±10.1岁。67例患者（27%）此前曾接受过ONS治疗。大多数压疮位于骶骨（54%）和足跟（32%）。200毫升ONS的平均摄入量为每天2.3±0.56份，相当于46克蛋白质、6.9克精氨酸、575毫克维生素C、87毫克维生素E和21毫克锌。经过9周的营养支持，压疮平均面积从1580±3743平方毫米显著减少至743±1809平方毫米，减少了53%（p<0.0001）。分别有7%和20%的压疮在3周和9周后完全愈合。经过专门的营养支持后，渗出量（主观评估）也有所减少（p<0.0001）。
富含精氨酸、维生素C、维生素E和锌的高蛋白ONS与标准压疮护理联合使用时，可显著减少长期居住在养老院居民的平均压疮面积。
