Abstract
The objective of this multicenter open-label randomized study was for evaluating nutrition intervention on pressure ulcer healing. Tube-fed patients with Stages III to IV pressure ulcers were enrolled. Target energy levels to be given were the same value as at the time of enrollment or BEE×1.1 (activity factor)×1.1-1.3 (stress factor) in the control group, and BEE×1.1×1.3-1.5 in the intervention group. Both groups received the feeding formula Racol(®) for 12 weeks, and were prescribed to have pressure relief mattresses, and to unify the repositioning method, treatment drugs, and wound dressing materials. Ulcer sizes (length×width), nutritional state, and adverse events were evaluated. Energy levels administered to the control (n=29) and intervention (n=21) groups were 29.1±4.9 (mean±SD) and 37.9±6.5 kcal/kg/day, respectively. Regarding pressure ulcer size, the interaction between the nutrition intervention and the courses during observational weeks was significant (P<0.001). Similarly, significant differences were observed with weight, waist circumference, Cu (P<0.001), suprailiac skinfold thickness (P<0.01), thigh circumference, and prealbumin (P<0.05), but not with the incidence of adverse events (P=0.360). Principal component analysis indicated remarkable decreases in ulcer size and improvement rates of waist circumference and suprailiac skinfold thickness in the intervention group. Covariance structure analysis showed that nutrition intervention has a direct effect on reduction in ulcer size. The results suggested that aggressive nutrient intervention accelerated the pressure ulcer of wound healing process and had a direct effect on reduction in ulcer size.
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