School of Nutrition, Federal University of Goias, Goiânia, GO, Brazil.
School of Nursing, Federal University of Goias, Goiânia, GO, Brazil.
Nutrition. 2024 Aug;124:112449. doi: 10.1016/j.nut.2024.112449. Epub 2024 Apr 2.
Chronic wounds are characterized by prolonged non-healing, significantly affecting patients' quality of life. Oral formulas may enhance the wound healing process and contribute to cost reduction in care. This review aimed to evaluate the effects of oral nutritional supplementation on chronic wound healing and provide insights into formula characteristics. A comprehensive search across Cinahl, Embase, PubMed, and Web of Science databases yielded nine studies from the past decade involving 741 patients ages 52 to 81.7 across various care settings: hospitals, long-term care facilities, and home care. Primary wound types included pressure injuries (58%), diabetic foot ulcers (40%), and venous ulcers (2%). The intervention duration ranged from 2 to 16 wk, with sample sizes varying from 24 to 270 patients. Notably, four studies reported a reduction in wound area and an increased healing rate with a hypercaloric, hyperproteic formula enriched with zinc and vitamins A, C, and E. However, two studies found no significant differences compared with control groups. Two other studies investigated a combination of arginine, glutamine, and β-hydroxy-β-methylbutyrate; however, they did not yield significant results, and one study favored a hyperproteic formula instead of a hyperproteic formula with arginine. This review provides evidence supporting the potential of oral nutritional supplementation to enhance the healing process of chronic wounds. Based on our findings, a desirable formula should be characterized by a high calorie and protein content and the inclusion of antioxidant micronutrients, including, but not limited to, vitamins A, E, C, and zinc.
慢性伤口的特点是愈合时间延长，严重影响患者的生活质量。口服配方可能会促进伤口愈合过程，并有助于降低护理成本。本综述旨在评估口服营养补充对慢性伤口愈合的影响，并深入了解配方的特点。通过对 Cinahl、Embase、PubMed 和 Web of Science 数据库进行全面检索，从过去十年中获得了 9 项研究，涉及到来自不同护理环境（医院、长期护理机构和家庭护理）的 741 名年龄在 52 至 81.7 岁的患者。主要的伤口类型包括压力性损伤（58%）、糖尿病足溃疡（40%）和静脉溃疡（2%）。干预持续时间从 2 周到 16 周不等，样本量从 24 到 270 名患者不等。值得注意的是，四项研究报告称，高热量、高蛋白配方富含锌和维生素 A、C、E 可减少伤口面积并提高愈合率。然而，两项研究与对照组相比没有显著差异。另外两项研究调查了精氨酸、谷氨酰胺和 β-羟基-β-甲基丁酸的组合；然而，它们没有产生显著的结果，并且一项研究倾向于使用高蛋白配方而不是含有精氨酸的高蛋白配方。本综述提供了证据支持口服营养补充剂促进慢性伤口愈合过程的潜力。基于我们的发现，理想的配方应具有高热量和高蛋白含量，并包含抗氧化微量营养素，包括但不限于维生素 A、E、C 和锌。
