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Nutritional therapy and wound healing in pressure injury situations: an integrative review

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Abstract

Purpose

Pressure injuries represent a serious problem for health systems and are directly associated with increased morbimortality, longer lengths of hospital stay, and higher treatment costs. Factors like malnutrition, highly prevalent in the hospital environment, severely contribute to the genesis of these injuries. The adequate supply of nutrients may favor the healing capacity. The present study aims to compare different profiles of nutritional therapy and their effects on wound healing in situations of pressure injury.

Methods

An integrative review in which the search for bibliographic data was carried out from December 2019 to May 2020.

Results

Fourteen articles were included. The most frequently observed nutritional therapy approach was the hyperprotein enriched with arginine, zinc, and vitamin C. Eleven studies observed positive effects from therapy and three did not show statistically significant advantages from it. The patients were mostly elderly or malnourished.

Conclusion

Some nutrients have been used extensively in the treatment of pressure injuries and are often positively associated with the healing process, highlighting the hyperproteic nutritional therapy enriched with arginine, zinc, and vitamin C, although there is no consensus on the topic.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

HMB:

Beta-hydroxy-beta-methylbutyrate

CaHMB:

Beta-hydroxy-beta-methylbutyrate calcium salt

BMI:

Body mass index

CAPE:

Caffeic acid phenethyl ester

SDF1:

Chemokine stromal derived cell factor 1

DNA:

Desoxyribonucleic acid

DHA:

Docosahexaenoic acid

EPA:

Eicosapentaenoic acid

Foxo:

Forkhead box O

GLA:

Gamma linolenic acid

GSH:

Glutathione

GH:

Growth hormone

IGF-1:

Insulin-like growth factor 1

IL-1:

Interleukin 1

IL-6:

Interleukin 6

LTA4H:

Leukotriene A4 hydrolase

MUST:

Malnutrition Universal Screening Tool

MDA:

Malondialdehyde

mTOR:

Mammalian target of rapamycin

MNA:

Mini Nutritional Assessment

MCP-1:

Monocyte chemoattractant protein-1

MNTT:

Multidisciplinary nutritional therapy team

NPIAP:

National Pressure Injury Advisory Panel

NO:

Nitric oxide

NOS2:

Nitric oxide synthase-2

NRF2:

Nuclear factor-erythroid 2-related factor 2

NF-κB:

Nuclear factor kappa B

NT:

Nutritional therapy

PI:

Pressure injury

PSST:

Pressure score status tool

PUSH:

Pressure ulcer scale for healing

ROS:

Reactive oxygen species

RNA:

Ribonucleic acid

SMA1:

Smooth muscle actin 1

SGA:

Subjective Global Assessment

TGFβ:

Transforming growth factor β

TNF-α:

Tumor necrosis factor alpha

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Authors and Affiliations

  1. Department of Nutrition, School of Public Health, University of Sao Paulo, Avenida Dr. Arnaldo 715, Sao Paulo, 01246-904, Brazil

    Guilherme Vasques Segalla, Sarah Trindade Teixeira & Marcelo Macedo Rogero

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  1. Guilherme Vasques Segalla
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  2. Sarah Trindade Teixeira
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Contributions

M.M.R. was responsible for the study concept. The search of the studies and the initial manuscript preparation were performed by G.V.S. and S.T.T. who were also responsible for the study analyses, design, and writing of the manuscript. The manuscript was revised by M.M.R. All authors read and approved the final manuscript.

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Correspondence to Marcelo Macedo Rogero.

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The authors declare no competing interests.

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Segalla, G.V., Teixeira, S.T. & Rogero, M.M. Nutritional therapy and wound healing in pressure injury situations: an integrative review. Nutrire 46, 21 (2021). https://doi.org/10.1186/s41110-021-00147-3

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