Nutritional care of patients with pressure ulcers: Some evidence based guidelines

Malnutrition has been shown to be a significant factor in the development and deterioration of pressure ulcers (PU). However, whether nutritional intervention can be effective in the treatment of PU is still unclear and controversial mainly due to inconsistent results reported in some recent studies. The objective of this review is to evaluate the effectiveness of nutritional care in patients with PU. The review is expected to comprehend the definition, prevalence and effectiveness of nutritional care on the prevention and treatment of PU. In addition a discussion on the level of adequacy of nutritional care and the role of enteral and parenteral nutrition on the prevention and treatment of PU is also provided. Sources of Data/Study selection: Data from survey reports, health statistics, descriptive, cross-sectional and longitudinal studies published between 1990-2008 on the topic were included. Data searches concentrated on human studies only excluding those with irrelevant and incomplete conclusions. Data Extraction: The literature was accessed using data bases and abstracting systems including Medline, PubMed, Science Direct, Research GATE, etc. The prevalence of PU may range from 5-50%. Nutritional status is an independent risk factor for the development of pressure ulcers. Data from nutrition supplementation studies show faster recovery from PU and lesser hospital stay. Diets with high energy and protein, supplemented with vitamins, minerals and immunomodulators are generally indicated in PU. Enteral and parenteral nutrition are indicated when the patient fails to achieve nutritional needs through oral route and are recommended to be used without any contraindications.