Wong A, Chew A, Wang CM, Ong L, Zhang SH, Young S, et al.
Journal of wound care. Date of publication 2014 May 1;volume 23(5):259-60, 262-4, 266-9.
1. J Wound Care. 2014 May;23(5):259-60, 262-4, 266-9.
The use of a specialised amino acid mixture for pressure ulcers: a
placebo-controlled trial.
Wong A(1), Chew A(2), Wang CM(3), Ong L(3), Zhang SH(1), Young S(4).
Author information:
(1)MSc, RD, Department of Dietetics and Food Services, Changi General Hospital,
Singapore.
(2)BSc, RN, Department of Nursing, Case Management Unit, Changi General Hospital,
Singapore.
(3)B Nursing, RN, Department of Nursing, Case Management Unit, Changi General
Hospital, Singapore.
(4)MD, Department of Rehabilitative Medicine, Changi General Hospital, Singapore.
OBJECTIVE: To compare pressure ulcer healing rates in patients supplemented with
a specialised amino acid mixture containing (beta)-hydroxy (beta)-methylbutyrate
(HMB), arginine and glutamine, and standard oral nutritional supplements versus
patients supplemented with oral nutritional supplements and a placebo mixture.
METHOD: Twenty-three inpatients with stage II, III or IV pressure ulcers in an
acute care hospital were randomised to recieve (A) a HMB, arginine and glutamine
mixture twice daily alongside oral nutritional supplements (n=11) or (B) standard
nutritional care alongside oral nutritional supplements (n=12) for 2 weeks.
Pressure ulcers were measured weekly for area, depth and Pressure Ulcer Scale for
Healing (PUSH) scores. The proportion of viable tissue was determined based on
area of wound tracing. Weekly laboratory tests were performed to measure
C-reactive protein and pre-albumin levels. This trial is registered at
http://ClinicalTrials.gov under NCT01090076.
RESULTS: There was no difference between anthropometrical measurements,
biochemical parameters and nutritional intake pre- and post- study. Wound area
did not decrease significantly in the short term for both groups. The proportion
of viable tissues increased within 2 weeks on HMB, arginine and glutamine
supplementation (p=0.02). PUSH scores showed significant improvement within 1
week of supplementation for the experimental group (p=0.013).
CONCLUSION: The use of specialised amino acid does not appear to reduce wound
size and PUSH scores but may improve tissue viability after 2 weeks. Further
confirmation on a larger scale is required to determine the benefits of
supplementing additional HMB, arginine and glutamine in patients with pressure
ulcers.
DOI: 10.12968/jowc.2014.23.5.259
PMID: 24810310 [Indexed for MEDLINE]
