LAUSR

Abstract Purpose Pressure ulcers are a common, potentially mortal complication to disease, care and treatment for patients of all ages with mobility impairments. In addition, pressure ulcers not always heal straightforward because of multiple intrinsic factors e.g. undernutrition and extrinsic factors e.g. inadequate nutrition that may influence the healing process. The aim of this descriptive review is to investigate the treatment effect of arginine-enriched oral nutritional supplementation in pressure ulcers. Results The included studies, seven RCTs and four CTs, were published between January 2001 and October 2015, and conducted in different settings: hospital, long-term care/care homes and home care. The duration of follow-up of the studies varied from 2 weeks to complete healing and the sample size varied from 16 to 245 patients aged from 37 to 92 years and with pressure ulcer stages II, III or IV. The wound-specific oral nutritional supplementation contained 3–9 g of arginine. The main outcome measures were complete healing, time needed for complete wound closure, reduction in wound surface area, nursing time, and the number of dressings used. Ten out of eleven studies showed a beneficial effect of the arginine-enriched oral nutritional supplementation on the healing of pressure ulcers. Conclusions This review shows that there is substantial evidence supporting the positive effect of nutritional supplementation with additional protein, arginine and micronutrients to promote pressure ulcer healing. Currently, there is only one large study (N = 200) with level 1 evidence. It may be postulated that at least one extra comparable level 1 study is needed to draw firm conclusions on the importance of key nutrients in complete pressure ulcer healing.