Cochrane · systematic review · CD003216
Nutritional interventions for preventing and treating pressure ulcers
Langer, G, Wan, CS, Fink, A, et al. · Cochrane Database of Systematic Reviews · 2024 · Cochrane Library
WoundsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
41
current version
GRADE rated
16
No studies
25
Included studies
NR
No studies 25 · 61%Ungraded 0 · 0%Very low 8 · 19.5%Low 6 · 14.6%Moderate 2 · 4.9%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings table ‐ Energy, protein and micronutrients compared to standard diet for the prevention of pressure ulcers
Population: inpatients who are mildly or seriously malnourished or at risk of being malnourished, elderly patients at risk of developing pressure ulcers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of pressure ulcers Summary of findings table ‐ Energy, protein and micronutrients vs standard diet | RR 0.92 [0.71, 1.19] | 3 studies · 1634 participants | Low Downgraded: risk of bias |
Time to pressure ulcer development ‐ not reported Summary of findings table ‐ Energy, protein and micronutrients vs standard diet | no estimate extracted | NR | No studies |
Acceptability of nutritional supplements ‐ not reported Summary of findings table ‐ Energy, protein and micronutrients vs standard diet | no estimate extracted | NR | No studies |
Side effects ‐ not reported Summary of findings table ‐ Energy, protein and micronutrients vs standard diet | no estimate extracted | NR | No studies |
Costs ‐ not reported Summary of findings table ‐ Energy, protein and micronutrients vs standard diet | no estimate extracted | NR | No studies |
Health‐related quality of life ‐ not reported Summary of findings table ‐ Energy, protein and micronutrients vs standard diet | no estimate extracted | NR | No studies |
Summary of findings table ‐ Protein compared to standard diet for the prevention of pressure ulcers
Population: patients (> 65 years) following hip fracture; patients with a recent stroke
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of pressure ulcers Summary of findings table ‐ Protein vs standard diet | RR 0.75 [0.49, 1.14] | 4 studies · 4264 participants | Low Downgraded: risk of bias, imprecision |
Time to pressure ulcer development ‐ not reported Summary of findings table ‐ Protein vs standard diet | no estimate extracted | NR | No studies |
Acceptability of nutritional supplements ‐ not reported Summary of findings table ‐ Protein vs standard diet | no estimate extracted | NR | No studies |
Side effects: at least one adverse gastrointestinal event Summary of findings table ‐ Protein vs standard diet | RR 0.7 [0.06, 7.96] | 2 studies · 140 participants | Very low Downgraded: risk of bias, imprecision |
Costs ‐ not reported Summary of findings table ‐ Protein vs standard diet | no estimate extracted | NR | No studies |
Health‐related quality of life ‐ not reported Summary of findings table ‐ Protein vs standard diet | no estimate extracted | NR | No studies |
Summary of findings table ‐ Energy, protein and micronutrients compared to standard diet for treating pressure ulcers
Population: long‐term care patients; inpatients without dehydration with energy intake by tube feeding; patients with pressure ulcers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pressure ulcers healed Summary of findings table ‐ Energy, protein and micronutrients vs standard diet | RR 1.45 [1.14, 1.85] | 3 studies · 577 participants | Low Downgraded: risk of bias |
Time to complete healing of pressure ulcers ‐ not reported Summary of findings table ‐ Energy, protein and micronutrients vs standard diet | no estimate extracted | NR | No studies |
Change in area/depth/volume of pressure ulcers ‐ not reported Summary of findings table ‐ Energy, protein and micronutrients vs standard diet | no estimate extracted | NR | No studies |
Acceptability of nutritional supplements ‐ not reported Summary of findings table ‐ Energy, protein and micronutrients vs standard diet | no estimate extracted | NR | No studies |
Side effects: at least one adverse gastrointestinal event Summary of findings table ‐ Energy, protein and micronutrients vs standard diet | RR 1.6 [0.59, 4.33] | 1 study · 60 participants | Very low Downgraded: risk of bias, imprecision |
Costs ‐ not reported Summary of findings table ‐ Energy, protein and micronutrients vs standard diet | no estimate extracted | NR | No studies |
Health‐related quality of life ‐ not reported Summary of findings table ‐ Energy, protein and micronutrients vs standard diet | no estimate extracted | NR | No studies |
Summary of findings table ‐ Protein, arginine, zinc and antioxidants compared to standard diet or placebo for treating pressure ulcers
Population: residents of long‐term care (≥ 65 years) with pressure ulcers; inpatients with pressure ulcers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pressure ulcers healed Summary of findings table ‐ Protein, arginine, zinc and antioxidants vs standard diet or placebo | RR 1.25 [0.49, 3.15] | 2 studies · 61 participants | Very low Downgraded: risk of bias, imprecision |
Time to complete healing of pressure ulcers ‐ not reported Summary of findings table ‐ Protein, arginine, zinc and antioxidants vs standard diet or placebo | no estimate extracted | NR | No studies |
Pressure ulcer area (absolute) Summary of findings table ‐ Protein, arginine, zinc and antioxidants vs standard diet or placebo | no estimate extracted | 2 studies · 71 participants | Very low Downgraded: risk of bias, imprecision |
Acceptability of nutritional supplements ‐ not reported Summary of findings table ‐ Protein, arginine, zinc and antioxidants vs standard diet or placebo | no estimate extracted | NR | No studies |
Side effects: at least one adverse gastrointestinal event Summary of findings table ‐ Protein, arginine, zinc and antioxidants vs standard diet or placebo | RR 1.17 [0.77, 1.79] | 1 study · 43 participants | Very low Downgraded: risk of bias, imprecision |
Costs ‐ not reported Summary of findings table ‐ Protein, arginine, zinc and antioxidants vs standard diet or placebo | no estimate extracted | NR | No studies |
Health‐related quality of life ‐ not reported Summary of findings table ‐ Protein, arginine, zinc and antioxidants vs standard diet or placebo | no estimate extracted | NR | No studies |
Summary of findings table ‐ Arginine and micronutrients compared to standard diet for treating pressure ulcers
Population: malnourished patients with pressure ulcers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pressure ulcers healed Summary of findings table ‐ Arginine and micronutrients vs standard diet | RR 1.67 [0.8, 3.46] | 1 study · 200 participants | Low Downgraded: imprecision |
Time to complete healing of pressure ulcers ‐ not reported Summary of findings table ‐ Arginine and micronutrients vs standard diet | no estimate extracted | NR | No studies |
Change in pressure ulcer area (cm²) Summary of findings table ‐ Arginine and micronutrients vs standard diet | no estimate extracted | 1 study · 31 participants | Low Downgraded: risk of bias, imprecision |
Change in pressure ulcer area (percentage) Summary of findings table ‐ Arginine and micronutrients vs standard diet | no estimate extracted | 2 studies · 231 participants | Low Downgraded: risk of bias, imprecision |
Acceptability of nutritional supplements: non‐adherence Summary of findings table ‐ Arginine and micronutrients vs standard diet | RR 15.6 [0.94, 259] | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision |
Side effects: at least one adverse gastrointestinal event Summary of findings table ‐ Arginine and micronutrients vs standard diet | RR 1.54 [0.36, 6.64] | 3 studies · 282 participants | Very low Downgraded: risk of bias, imprecision |
Costs (EUR) Summary of findings table ‐ Arginine and micronutrients vs standard diet | no estimate extracted | 1 study · 138 participants | Moderate Downgraded: imprecision |
Health‐related quality of life ‐ not reported Summary of findings table ‐ Arginine and micronutrients vs standard diet | no estimate extracted | NR | No studies |
Summary of findings table ‐ Collagen compared to standard diet or placebo for treating pressure ulcers
Population: adult inpatients or outpatients with pressure ulcers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pressure ulcers healed ‐ not reported Summary of findings table ‐ Collagen vs standard diet or placebo | no estimate extracted | NR | No studies |
Time to complete healing of pressure ulcers ‐ not reported Summary of findings table ‐ Collagen vs standard diet or placebo | no estimate extracted | NR | No studies |
Change in pressure ulcer area (cm²) Summary of findings table ‐ Collagen vs standard diet or placebo | no estimate extracted | 1 study · 74 participants | Moderate Downgraded: imprecision |
Acceptability of nutritional supplements ‐ not reported Summary of findings table ‐ Collagen vs standard diet or placebo | no estimate extracted | NR | No studies |
Side effects: at least one adverse event Summary of findings table ‐ Collagen vs standard diet or placebo | RR 2.69 [0.33, 22.3] | 2 studies · 154 participants | Very low Downgraded: risk of bias, imprecision |
Costs ‐ not reported Summary of findings table ‐ Collagen vs standard diet or placebo | no estimate extracted | NR | No studies |
Health‐related quality of life ‐ not reported Summary of findings table ‐ Collagen vs standard diet or placebo | no estimate extracted | NR | No studies |