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Research Objectives
Assess utilization and impact of a specialized oral nutrition supplement (ONS) containing
arginine, glutamine, and hydroxymethylbutyrate (HMB) on wound healing.
Design
Retrospective analysis comparing treatment group (51 patients, 161 wounds) receiving
standard care plus a specialized ONS for ≥14 days and comparison group (136 patients,
263 wounds) receiving standard care. Between group differences evaluated using t-tests
and mixed models with inverse probability weighting.
Setting
Inpatient rehabilitation hospital.
Participants
187 adult patients admitted between 1/2018-12/2019 with ≥1 measured wound and ≥2 wound
care nurse assessments.
Interventions
Specialized oral nutrition supplement administered for 14 days.
Main Outcome Measures
Wound healing was measured in weekly intervals by decrease in wound surface area (superficial)
or volume (non-superficial) in past 1 week.
Results
While no age differences were reported between groups (50.9 vs 51.0 years, p=1.0),
the treatment group had a higher percentage of male patients (90.2% vs 69.9%, p<0.01).
Treatment group patients had more wounds (3.3 vs 2.0, p<0.01), lower functional independence
measure scores (35.7 vs 40.3, p=0.082), and a higher case mix index (2.3 vs. 2.0,
p=0.008) at baseline. Average inpatient stay (44. 8 vs 39.9 days, p=0.36) and wound
area at baseline (22.0 vs 13.1 cm2, p=0.18) were higher, but not statistically different,
in the treatment group. Treatment group wounds significantly decreased in area (61.0%
vs 34.6%, p=0.01) compared to comparison group wounds. The odds of a decrease in wound
size were higher in the treatment versus comparison group (OR = 24.1, p<0.01).
Conclusions
Patients receiving specialized ONS had more wounds and higher acuity level than those
in the comparison group but had a significant reduction in wound size. There are several
limitations in this retrospective study, including baseline functional and wound size
differences. However, these findings support the benefits of specialized ONS in improving
wound healing for patients with pre-existing wounds.
Author(s) Disclosures
KW Kerr, S Sulo and JL Nelson are Abbott employees and stockholders.
Study financially supported by Abbott.
Keywords
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Copyright
© 2022 Published by Elsevier Inc.
