Abstract
We conducted a double blind, multi-centric, placebo-controlled, randomized trial to compare the Pressure Ulcer Scale for Healing (PUSH) and Pressure Sore Status Tool (PSST) scores and wound area measurements at 16 weeks of subjects with pressure ulcers who were given standard care plus one of two types of collagen hydrolysate (CH-a), which contained low levels of prolylhydroxyproline (Pro-Hyp) and hydroxyprolylglycine (Hyp-Gly), and CH-b, which contained high levels of Pro-Hyp and Hyp-Gly) with the placebo group. A total of 120 subjects with stage II or III pressure ulcers were entered into the trial and 112 subjects completed the study. The subjects were randomized to receive CH-a (n = 39), CH-b (n = 39), or a placebo (n = 42) twice daily (10 g per day) for 16 weeks. The PUSH score, PSST score, and wound area of the CH-b group were significantly lower than the placebo group at week 16 (PUSH score, P < 0.001; PSST score, P < 0.01; wound area, P < 0.05). The PUSH score of the CH-a group was significantly lower than the placebo group at week 16 (P < 0.05). This study demonstrated that CH-b ingestion helps healing of pressure ulcers as an add-on to the standard therapy.
Highlights
A pressure ulcer is defined as an area of localized damage to the skin and/or underlying tissue caused by pressure, or pressure in combination with shear stress
The present study demonstrated that the oral ingestion of Collagen hydrolysate (CH)-b, which contains higher concentrations of the free-form bioactive peptides Pro-Hyp and Hyp-Gly, resulted in significantly greater improvements in the PUSH score, Pressure Score Status Tool (PSST) score, and wound area compared with the ingestion of a placebo
The ingestion of CH-a, which contains lower concentrations of these bioactive peptides, produced significantly greater improvements in the PUSH score than the placebo. This effect of CH-a was supported by the previous finding that the ingestion of CH together with an amino acid mixture led to a significant improvement in the rate of change in the PUSH score within 8 weeks[9]
Summary
A pressure ulcer is defined as an area of localized damage to the skin and/or underlying tissue (usually over a bony prominence) caused by pressure, or pressure in combination with shear stress. Reddy M et al.[2] reviewed that protein supplementation of long-term care residents improved wound healing compared with a placebo (it brought about an improvement in the Pressure Ulcer Scale for Healing [PUSH] score). Collagen hydrolysate (CH), which is referred to as collagen peptides, is widely utilized as a nutritional supplement. It is a mixture of peptides of different molecular weights derived from gelatin, a form of heat-denatured collagen, via enzymatic hydrolysis. As for the effect of CH on pressure ulcers, Lee SK et al.[9] reported that the combined oral administration of CH, an amino acid mixture, and the standard treatment resulted in an improvement in the PUSH score after 8 weeks’ treatment. The objective of the present study was to assess the clinical effectiveness of CH supplementation in terms of its ability to induce remission in subjects with stage II or III pressure ulcers and the safety of this approach
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