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Nutritional Support in Pressure Ulcer Patients

Not Applicable
Completed
Conditions
Pressure Ulcers
Interventions
Dietary Supplement: Enriched nutrition formula
Dietary Supplement: Control formula
Registration Number
NCT01107197
Lead Sponsor
Azienda Ospedaliero Universitaria Maggiore della Carita
Brief Summary

Pressure ulcers are frequently associated with malnutrition. Previous studies have reported that nutritional support can improve the healing rate of pressure ulcers but no attention has been clearly given to the nutritional status of the patient treated. Moreover, other investigators have suggested the additional healing power of some nutrients. Unfortunately, previous results have been unpowered by small sample size, poor monitoring of compliance to treatments and the confounding effect of other nutrients. The investigators aimed to test the effect and additional benefits of several micronutrients delivered through oral nutritional support on the healing rate of pressure ulcers in malnourished patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
200
Inclusion Criteria
  • patient or legal guardian or caregiver consent
  • stage II, III or IV pressure ulcers
  • malnutrition (as defined by low body mass index and/or unintentional weight loss and/or low serum albumin and/or reduced food intake [<60% of total daily estimated requirements])
  • patients who can drink supplements
  • home-care or long-term care
Exclusion Criteria
  • decompensated diabetes (HbA1C >7%)
  • renal failure
  • hepatic failure (Child B and C)
  • current neoplastic disease
  • any organ-failure
  • immunosuppressive therapy
  • connective tissue disease
  • use of steroids
  • obesity
  • respiratory insufficiency (COPD)
  • anemia (haemoglobin <10g/dL)
  • previous neoplastic disease (<1 year since last treatment CT or RT)
  • infected wounds
  • cellulitis, sepsis or osteomyelitis
  • poor tolerance to sip feeding

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Enriched nutrition formulaEnriched nutrition formulaPatients were given standard diet plus 2 bottles of an hypercaloric oral formula enriched in arginine, zinc and antioxidant oligoelements
Isonitrogenous isocaloric formulaControl formulaPatients were given standard diet plus 2 bottles of an hypercaloric oral formula isonitrogenous isocaloric to the experimental one
Primary Outcome Measures
NameTimeMethod
Rate of Healing8 weeks of nutritional support (baseline and week 8)

healing is defined as reduction in ulcer area (the percentage of change)

Secondary Outcome Measures
NameTimeMethod
Incidence of Infections8 weeks of nutritional support (baseline and week 8)

defined as local (ulcer)

Rate of Healing8 weeks of nutritional support (baseline and week 8)

complete healing

the Percentage of Change in Area4 weeks of nutritional support (baseline and week 4)

the reduction in ulcer area (%) observed at 4 weeks

Cost-effectiveness8 weeks of nutritional support (baseline and week 8)

Incremental cost-effectiveness ratio (ICER) was calculated by dividing the difference between total costs (active - control) by the difference in the mean reduction (%) of ulcer area. Costs are derived from oral nutritional supplements, dressings, antibiotics, PU swab sampling, nurse visits for wound dressing (according to their duration and cost per hour), medical consultations (unitary cost of the visit for prescription of antibiotic therapy).

Dressings8 weeks of nutritional support (baseline and week 8)

The number of dressings used throughout the intervention period

Trial Locations

Locations (1)

Azienda Ospedaliero Universitaria Maggiore della Carita

🇮🇹

Novara, Italy

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