Kan nutritionsbehandling bidra till läk-ning av trycksår bland äldre patienter?
Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionTitle: Can nutritional support contribute to the healing of pressure ulcers in elderly patients?Author: Anton Kinnander, Sandra SmidelikSupervisor: Elisabet RothenbergExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: 12-04-11Background The number of elderly patients with co-morbidity is increasing in the western world. It is therefore reasonable to predict increasing incidence and prevalence of pressure ulcers. One study, published 2009, found that as many as 59 % of geriatric patients within the Swedish health care system had developed pressure ulcers. Symptoms vary from mild erythema to severe deep tissue damage and development of pressure varies from hours to weeks. Risk factors include; high age, dysmobility and malnutrition, making elderly patients at high risk for developing pres-sure ulcers. Even if the foremost known treatment is avoiding frequent pressure at bony sites, nutrition is becoming an emerging factor.Objective To evaluate the evidence for nutritional treatment on healing of pressure ulcers among elderly patients.Search strategy Data collection was performed in the search engines PubMed and Scopus in Febru-ary of 2012. Search terms used were the following; ?Pressure ulcer nutrition?, ?Pressure ulcer Nutrition Elderly RCT Treatment?, ?Pressure ulcer nutritional supplementation?.Selection criteria The included studies were original articles, in Swedish or English, and studied the effect of nutritional support on pressure ulcer healing. The studies had to be human RCT (ran-domized controlled trial) with elderly patients (>65 years of age), both men and women. The primary endpoint were changes of the surface area of the pressure ulcers (length x width) and the secondary changes in the PUSH-scale score.Data collection and analysis The data collection was performed according to the selection criteria?s. They were analyzed using a standardized template for RCT published by SBU. The studies were added together and evaluated by the ?Sammanfattande evidensformulär? published by the Insti-tution for Internal medicine and Clinical nutrition, the Sahlgrenska Academy.Main results Three studies were included and they all showed a significant positive effect on the reduction of the surface area of pressure ulcers due to nutritional support. Two of them showed significant changes of the score in the PUSH-scale. The joint evidence value of the studies was moderate, regarding both endpoints.Conclusions Results demonstrates that nutritional support has a positive effect on the healing of pressure ulcers in elderly patients. More research is needed to determine optimal composition of nutritional support for the healing of pressure ulcers.