Gutman Jimmy B L, Kongshavn Patricia A L
Senior Medical Adviser, Immunotec Inc., 300 Joseph Carrier, Vaudreuil-Dorion, QC Canada.
Scientific Advisory Board Member, Immunotec Inc., 24-520 Marsett Place, Victoria, BC, Canada.
J Wound Care. 2019 Jul 1;28(Sup7):S16-S23. doi: 10.12968/jowc.2019.28.Sup7.S16.
The prevalence and costs associated with treating pressure ulcers (PU) are at high levels. Frequently, PUs heal slowly or not at all, which may be due to the patient's catabolic state which may include protein energy malnutrition. The objective of this open label clinical trial was to improve healing rates by providing patients with a patented, high-quality protein containing all essential amino acids to ensure positive nitrogen balance. An additional benefit of this protein is the delivery of bioavailable cysteine (cystine) to promote glutathione (GSH) synthesis which supports immune function and heightens antioxidant defences.
Patients with category II, III and IV PUs were fed 20g BID whey protein dietary supplement for 16-120 days, without change in ongoing 'best practice' PU management and their progress recorded.
A total of 10 patients were recruited, with an average age of 77 years. Most had shown no improvement in healing for ≥2 months before treatment and usually had other complications including chronic obstructive pulmonary disease (COPD), diabetes and various cardiovascular diseases. There were a total of 23 PUs, with some patients having more than one. Of these, 44% (n=10) showed complete resolution 83% (n=19) had better than 75% resolution over the observation period. Healing rates ranged from 16.9-0.2cm/month (healed PUs) and 60.0-1.6cm/month for resolving PUs.
By providing the necessary amino acids to rebuild tissues and bioactive cysteine (cystine) to promote synthesis of intracellular GSH and positive nitrogen balance, improvement in PUs healing was achieved.
与治疗压疮（PU）相关的患病率和成本居高不下。压疮通常愈合缓慢或根本不愈合，这可能是由于患者的分解代谢状态，其中可能包括蛋白质能量营养不良。这项开放标签临床试验的目的是通过为患者提供一种含有所有必需氨基酸的专利优质蛋白质来改善愈合率，以确保正氮平衡。这种蛋白质的另一个好处是提供生物可利用的半胱氨酸（胱氨酸）以促进谷胱甘肽（GSH）的合成，从而支持免疫功能并增强抗氧化防御。
患有II、III和IV期压疮的患者每天分两次服用20克乳清蛋白膳食补充剂，持续16 - 120天，同时维持正在进行的“最佳实践”压疮管理不变，并记录他们的进展情况。
共招募了10名患者，平均年龄为77岁。大多数患者在治疗前≥2个月愈合情况没有改善，并且通常还患有其他并发症，包括慢性阻塞性肺疾病（COPD）、糖尿病和各种心血管疾病。总共有23处压疮，有些患者有多处压疮。其中，44%（n = 10）的压疮完全愈合，83%（n = 19）的压疮在观察期内愈合超过75%。愈合率范围为愈合的压疮每月16.9 - 0.2厘米，正在愈合的压疮每月60.0 - 1.6厘米。
通过提供重建组织所需的氨基酸以及生物活性半胱氨酸（胱氨酸）来促进细胞内GSH的合成和正氮平衡，实现了压疮愈合的改善。
