Ernährung des nicht kritisch kranken Wundpatienten – spezielle Supplemente

Abstract

OBJECTIVE This study determined the strength of the evidence for supplementing non-critically ill patients with arginine, glutamine, vitamins A, C, and E and zinc to improve wound healing, and to develop recommendations for clinical practice. METHODS A literature research and review of all studies on human subjects relating to the topic was conducted. The studies were interpreted and recommendations for clinical practice developed. RESULTS To date, there is no strong evidence for any of the supplements in question. Evidence from trials on human subjects are non-existent for vitamins A and E, weak in the case of vitamin C and glutamine and moderate for zinc and arginine. Patients with wounds from surgery as well as patients with pressure sores may benefit from a supplementation of 500 mg vitamin C twice a day and, if patients with these wound categories exhibit low plasma zinc levels at baseline, they may also benefit from a supplementation of 40 mg zinc / d over a period of at least 2 weeks. Furthermore, the evidence suggests an improvement in wound healing in patients supplemented with at least 17 g of arginine / d. Oral ulcerations may heal faster if patients are given at least 7.5 g of glutamine / d as swish and swallow solutions. CONCLUSION Evidence to date suggests that wound healing may be improved with specific supplementations. However, more studies are needed to improve the data and to deal with unanswered questions.