The importance of dietary protein in healing pressure ulcers

J Am Geriatr Soc. 1993 Apr;41(4):357-62. doi: 10.1111/j.1532-5415.1993.tb06940.x.

Abstract

Objective: To determine the effect of dietary protein on healing of pressure ulcers in malnourished patients.

Design: Nutritional intervention trial with the non-randomized assignment of patients by pressure ulcer stage and bed type.

Setting: Long-term care facility.

Patients: Twenty-eight malnourished patients (age = 72 +/- 18 years, mean +/- SD) with a total of 33 truncal pressure ulcers. Nine patients had stage II ulcers, eight had stage III ulcers, and 16 had stage IV ulcers.

Methods: Patients received liquid nutritional formulas as tubefeedings or meal supplements containing either 24% protein (61 g protein/L; n = 15) or 14% protein (37 g protein/L; n = 13) for 8 weeks.

Results: There was a significant decrease in total truncal pressure ulcer surface area of the 15 patients in the 24% protein group (-4.2 +/- 7.1 cm2, P < 0.02), but not in the 13 patients in the 14% protein group (-2.1 +/- 11.5 cm2, P = NS). The change in total ulcer area correlated with both dietary protein intake per kg body weight (rs = -0.50, P < 0.01) and caloric intake per kg body weight (rs = -0.41, P < 0.03). The decrease in stage IV ulcer area in eight patients in the 24% protein group (-7.6 +/- 5.8 cm2, P < 0.02) was significantly greater (P < 0.05) than in eight patients in the 14% protein group (-3.2 +/- 16.4, P = NS). In these 16 patients, the decrease in ulcer size also correlated with dietary protein intake per kg body weight (rs = -0.63, P < 0.01).

Conclusion: High protein diets may improve the healing of pressure ulcers in malnourished nursing home patients.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Baltimore / epidemiology
  • Body Surface Area
  • Body Weight
  • Dietary Proteins / administration & dosage*
  • Energy Intake
  • Enteral Nutrition / standards*
  • Female
  • Humans
  • Male
  • Nursing Homes
  • Nutritional Status
  • Pressure Ulcer / complications*
  • Pressure Ulcer / epidemiology
  • Pressure Ulcer / pathology
  • Protein-Energy Malnutrition / complications
  • Protein-Energy Malnutrition / diagnosis
  • Protein-Energy Malnutrition / therapy*
  • Risk Factors
  • Wound Healing

Substances

  • Dietary Proteins