Faculty Medicine, Nursing and Health Sciences, School of Nursing and Midwifery, Monash University, Melbourne, Vic., Australia.
School of Clinical Sciences, Department Nutrition, Dietetics and Food, Monash University, Melbourne, Vic., Australia.
J Adv Nurs. 2018 Apr;74(4):774-787. doi: 10.1111/jan.13474. Epub 2017 Nov 9.
To identify the associations and effects of nutritional characteristics and interventions on ulcer outcomes in adult patients with venous leg ulcers.
Venous leg ulcers are the most prevalent type of lower limb ulcer; however, little evidence exists regarding the relationship between nutritional status and ulcer healing.
A systematic search of English language articles was conducted using the Cochrane Collaboration Handbook for Systematic Reviews of Interventions.
A search of databases Ovid MEDLINE, EMBASE, Cochrane, CINAHL and Scopus was performed for studies published between January 2004 - May 2017.
Quality of the included studies was assessed using the Cochrane Collaboration's Risk of Bias Assessment tool and the relevant Joanna Briggs Institute quality appraisal checklists.
Twenty studies met the inclusion criteria. All participants had Clinical Aetiology Anatomy Pathophysiology classification C5 (healed) or C6 (active) ulcers. Studies were conducted in a range of clinical settings with relatively small sample sizes. The majority of patients were overweight or obese. Increased body mass index was associated with delayed wound healing. Vitamin D, folic acid and flavonoids were associated with some beneficial effects on ulcer healing. Dietary intakes of omega-3 fatty acids, vitamin C and zinc were low for some patients.
Current evidence suggests that venous leg ulcer patients are more likely to be overweight or obese. However, evidence for weight management improving wound healing is lacking. Micronutrients, including vitamin D and folic acid, may improve wound healing in at-risk patients.
确定营养特征和干预措施对成人静脉性腿部溃疡患者溃疡结局的关联和影响。
静脉性腿部溃疡是最常见的下肢溃疡类型；然而，关于营养状况与溃疡愈合之间的关系，证据很少。
使用 Cochrane 协作组干预措施系统评价手册对英文文献进行了系统搜索。
在 2004 年 1 月至 2017 年 5 月期间，对 Ovid MEDLINE、EMBASE、Cochrane、CINAHL 和 Scopus 数据库进行了检索，以寻找已发表的研究。
评估了纳入研究的质量，使用了 Cochrane 协作组的偏倚风险评估工具和相关的 Joanna Briggs 研究所质量评估检查表。
有 20 项研究符合纳入标准。所有参与者的临床病因解剖病理生理学分类均为 C5（愈合）或 C6（活动）溃疡。这些研究在各种临床环境中进行，样本量相对较小。大多数患者超重或肥胖。体重指数增加与伤口愈合延迟有关。维生素 D、叶酸和类黄酮与溃疡愈合的某些有益效果有关。一些患者的ω-3 脂肪酸、维生素 C 和锌的膳食摄入量较低。
目前的证据表明，静脉性腿部溃疡患者更有可能超重或肥胖。然而，缺乏关于体重管理改善伤口愈合的证据。包括维生素 D 和叶酸在内的微量营养素可能会改善高危患者的伤口愈合。
