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Journal of Nursing ›› 2018, Vol. 25 ›› Issue (20): 24-30.doi: 10.16460/j.issn1008-9969.2018.20.024

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Effect of Enteral Nutritional Supplements on Prevention and Treatment of Pressure Ulcers: A Systematic Review

ZHAO Shi-yu, KE Hui, LI Meng-yuan, XIONG Can, YU Jiao-hua   

  1. Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
  • Received:2018-04-03 Published:2020-07-06

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Abstract: Objective To systematically evaluate the clinical effects of enteral nutrition supplements on the prevention and treatment of pressure ulcers. Methods Randomized controlled trials (RCTs) were retrieved from CNKI, WanFang database, VIP, Cochrane Library, Medline, EMbase, Web of Science and PubMed. RevMan 5.3 software was used for statistical analysis after the literature quality was evaluated strictly and the data was extracted. Results Twenty RCTs were included. Meta-analysis showed that enteral nutrition supplements could reduce the incidence of pressure ulcers [RR=0.81,95%CI(0.71,0.91), P=0.0008], improve the cure rate of pressure ulcer [RR=1.53,95%CI(1.28,1.83), P<0.00001] and reduce pressure ulcer area [SMD=-1.11,95%CI（-1.39,-0.82）,P<0.00001] without increasing the incidence of adverse reactions [RR=0.78,95%CI(0.37,1.63), P=0.51] but it could not reduce the healing score of pressure ulcers [MD=-0.68,95%CI(-1.47, 0.1), P=0.09]. Conclusion Enteral nutrition supplements have advantages in reducing the incidence of pressure ulcer, improving the cure rate of pressure ulcer and reducing the area of pressure ulcer,while the effect of reducing pressure ulcer healing score and shortening the healing time and whether increasing the incidence of adverse reactions is still not certain. Large and high-quality randomized controlled trials are needed to confirm its effect.

Key words: enteral nutrition, nutritional supplement, pressure sore, systematic review

CLC Number: 

  • R248.1
[1] Sedmak D, Vrhovec M, Huljev D.Prevention of Pressure Ulcer (bedsore)[J]. Acta Med Croatica, 2013,1(Suppl 1):29-34.
[2] Boyko T V, Longaker M T, Yang G P.Review of the Current Management of Pressure Ulcers[J]. Adv Wound Care (New Rochelle),2018,7(2):57-67. DOI:10.1089/wound.2016.0697.
[3] Still M D, Cross L C, Dunlap M, et al.The Turn Team: A Novel Strategy for Reducing Pressure Ulcers in the Surgical Intensive Care Unit[J]. J Am Coll Surg, 2013,216(3):373-379. DOI:10.1016/j.jamcollsurg.
[4] Pimiento J M, Echeverri S.Pressure Ulcers and Malnutrition: A Devastating and Common Association[J]. Nutrition, 2014,30(3):370-371. DOI:10.1016/j.nut.2013.08.007.
[5] Elizabeth M, Asmara J, EM B S, et al. Support Surfaces for Pressure Ulcer Prevention[J]. Cochrane Database Syst Rev, 2015(9):CD001735.DOI:10.1002/14651858.CD001735.pub5.
[6] Posthauer M E, Banks M, Dorner B, et al.The Role of Nutrition for Pressure Ulcer Management: National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance White Paper[J]. Adv Skin Wound Care, 2015,28(4):175-188. DOI:10.1097/01.ASW.0000461911.31139.62.
[7] Saghaleini S H, Dehghan K, Shadvar K, et al.Pressure Ulcer and Nutrition[J]. Indian J Crit Care Med, 2018,22(4):283-289.
[8] Cox J, Rasmussen L.Enteral Nutrition in the Prevention and Treatment of Pressure Ulcers in Adult Critical Care Patients[J].Crit Care Nurse,2014,34(6):15-27.DOI:10.4037/ccn2014950.
[9] Avenell A, Smith T O, Curtain J P, et al. Nutritional Supplementation for Hip Fracture after Care in Older People[J]. Cochrane Database Syst Rev, 2016(11):CD001880. DOI:10.1002/14651858.CD001880.pub6.
[10] Schols J M G A, Heyman H, Meijer E P. Nutritional Support in the Treatment and Prevention of Pressure Ulcers: An Overview of Studies with An Arginine Enriched Oral Nutritional Supplement[J]. J Tissue Viability, 2009,18(3):72-79. DOI:10.1016/j.jtv.2009.03.002.
[11] 郭艳侠,蒋琪霞,马茜,等. 肠内营养预防和治疗压疮效果的Meta分析[J]. 护理管理杂志, 2015,15(4):253-256.
[12] 段霞,李娜,陈雪珊. 肠内营养制剂的特点和应用选择[J]. 中国社区医师, 2015,31(15):5-7. DOI:10.3969/j.issn.1007-614x.2015.15.1.
[13] Green S.Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series[M]. New Jersey:Wiley-Blackwell, 2008:102-108.
[14] Higgins J P T, Altman D G, Gotzsche P C, et al. The Cochrane Collaboration’s Tool for Assessing Risk of Bias in Randomised Trials[J]. BMJ, 2011,343(10):d5928. DOI:10.1136/bmj.d5928.
[15] Banks M D, Ross L J, Webster J, et al.Pressure Ulcer Healing with An Intensive Nutrition Intervention in An Acute Setting: A Pilot Randomised Controlled Trial[J]. J Wound Care,2016,25(7):384-392.DOI:10.12968/jowc.2016.25.7.384.
[16] Cereda E, Klersy C, Serioli M, et al.A Nutritional Formula Enriched with Arginine, Zinc, and Antioxidants for the Healing of Pressure Ulcers: A Randomized Trial[J]. Ann Intern Med, 2015, 162(3):167-174. DOI:10.7326/M14-0696.
[17] Pouyssegur V, Brocker P, Schneider S M, et al.An Innovative Solid Oral Nutritional Supplement to Fight Weight Loss and Anorexia: Open, Randomised Controlled Trial of Efficacy in Institutionalised, Malnourished Older Adults[J]. Age Ageing,2015,44(2):245-251.DOI:10.1093/ageing/afu150.
[18] Wong A, Chew A, Wang C M, et al.The Use of A Specialised Amino Acid Mixture for Pressure Ulcers: A Placebo-controlled Trial[J]. J Wound Care, 2014,23(5):259-269. DOI:10.12968/jowc.2014.23.5.259.
[19] 何永清,张红静,赵润平,等. 肠内营养支持对压疮愈合的影响[J]. 护理实践与研究, 2014,11(1):126-127. DOI:10.3969/j.issn.1672-9676.2014.01.072.
[20] Ohura T, Nakajo T, Okada S, et al.Effects of Nutrition Intervention for Pressure Ulcer Patients-healing Rate and Speed of Wound Size and Nutrition[J]. Nihon Ronen Igakkai Zasshi, 2013,50(3):377-383.
[21] Hisashige A, Ohura T.Cost-effectiveness of Nutritional Intervention on Healing of Pressure Ulcers[J]. Clin Nutr, 2012,31(6):868-874. DOI:10.1016/j.clnu.2012.04.013.
[22] 强杰,何永清,张敏. ICU危重患者应用肠内营养乳剂预防压疮效果观察[J].中国误诊学杂志,2011,11(5):1052-1053.
[23] 邢惠萍,何金凤,肖军. 肠内营养支持对Ⅱ度压疮患者的疗效观察[J]. 兵团医学, 2011,27(1):9-10.
[24] van Anholt R D, LMeijer E S, Heyman H, et al. Specific Nutritional Support Accelerates Pressure Ulcer Healing and Reduces Wound Care Intensity in Non-malnourished Patients[J]. Nutrition, 2010,26(9):867-872. DOI:10.1016/j.nut.2010.05.009.
[25] Brewer S, Desneves K, Pearce L, et al.Effect of An Arginine-containing Nutritional Supplement on Pressure Ulcer Healing in Community Spinal Patients[J]. J Wound Care, 2010,19(7):311-316.
[26] Cereda E, Gini A, Pedrolli C, et al.Disease-Specific, Versus Standard, Nutritional Support for the Treatment of Pressure Ulcers in Institutionalized Older Adults: A Randomized Controlled Trial[J]. J Am Geriatr Soc, 2009,57(8):1395-1402. DOI:10.12968/jowc.2010.19.7.48905.
[27] 朱珊,李菊珍,王智荣,等. 肠内营养对褥疮患者支持治疗效果观察[J]. 中国老年保健医学, 2009,7(4):56-57. DOI:10.3969/j.issn.1672-4860-B.2009.04.024.
[28] Theilla M, Singer P, Cohen J, et al.A Diet Enriched in Eicosapentanoic Acid, Gamma-linolenic Acid and Antioxidants in the Prevention of New Pressure Ulcer Formation in Critically Ill Patients with Acute Lung Injury: A Randomized, Prospective, Controlled Study[J]. Clin Nutr, 2007,26(6):752-757. DOI:10.1016/j.clnu.2007.06.015.
[29] Lee S K, Posthauer M E, Dorner B, et al.Pressure Ulcer Healing with A Concentrated, Fortified, Collagen Protein Hydrolysate Supplement: A Randomized Controlled Trial[J]. Adv Skin Wound Care, 2006,19(2):92-96.
[30] Houwing R H, Rozendaal M, Wouters-Wesseling W, et al.A Randomised, Double-blind Assessment of the Effect of Nutritional Supplementation on the Prevention of Pressure Ulcers in Hip-fracture Patients[J]. Clin Nutr, 2003,22(4):401-405.
[31] Bourdel-Marchasson I, Barateau M, Rondeau V, et al.A Multi-center Trial of the Effects of Oral Nutritional Supplementation in Critically Ill Older Inpatients. GAGE Group. Groupe Aquitain Geriatrique d’Evaluation[J]. Nutrition, 2000,16(1):1-5.
[32] Hartgrink H H, Wille J, Konig P, et al.Pressure Sores and Tube Feeding in Patients with A Fracture of the Hip: A Randomized Clinical Trial[J]. Clin Nutr, 1998,17(6):287-292.
[33] Ek A C, Unosson M, Larsson J.The Development and Healing of Pressure Sores Related to the Nutritional State[J]. Clin Nutr, 1991,10(5):245-250.
[34] Delmi M, Rapin C H, Bengoa J M, et al.Dietary Supplementation in Elderly Patients with Fractured Neck of the Femur[J]. Lancet, 1990,335(8696):1013-1016.
[35] 陈慧敏,陈燕,袁芳,等. 简易营养评价法及其精法在老年压疮患者营养评价中的应用[J]. 护理学报, 2011,18(9A):67-71. DOI:10.3969/j.issn.1008-9969.2011.17.021.
[36] Mulholland G D.Nutrition to Improve Outcome. Supplements to Promote Wound Healing[J]. Medsurg Nurs, 2015,24(1):2-3.
[37] 米元元,沈月,黄海燕,等. ICU患者肠内营养并发腹泻证据汇总[J]. 护理学报, 2017, 24(21):58-66. DOI:10.16460/j.issn1008-9969.2017.21.058.
[38] 周田田,王保荣,朱小芳,等. ICU脓毒症患者肠内营养喂养不耐受的相关因素分析[J]. 护理学报, 2017,24(16):6-9. DOI:10.16460/j.issn1008-9969.2017.16.006.
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