Impact of oral nutritional supplement composition on healing of different chronic wounds: A systematic review

•Oral nutritional supplementation enhances the healing process of chronic wounds.•Protein emerges as the pivotal macronutrient in facilitating chronic wound healing.•Antioxidants appear to play a crucial role in expediting the healing process.•Arginine does not appear to be a decisive factor in dete...

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Published in:Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2024-08, Vol.124, p.112449, Article 112449
Main Authors: Santo, Allan Carlos Soares do Espírito, Sugizaki, Clara Sandra de Araújo, de Morais Junior, Alcides Corrêa, Costa, Nara Aline, Bachion, Maria Marcia, Mota, João Felipe
Format: Article
Language:English
Subjects:
Bias
Biomarkers
Boolean
Chronic wound
Diabetes
Diabetes mellitus
Dietary supplements
Foot diseases
Glutamine
Intervention
Leg ulcers
Long-term care
Micronutrients
Nutrient content
Nutrition
Plantar ulcers
Pressure ulcers
Protein
Qualitative research
Quality of life
Supplement
Systematic review
Trauma
Ulcers
Vitamins
Wound healing
Zinc
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Summary:•Oral nutritional supplementation enhances the healing process of chronic wounds.•Protein emerges as the pivotal macronutrient in facilitating chronic wound healing.•Antioxidants appear to play a crucial role in expediting the healing process.•Arginine does not appear to be a decisive factor in determining healing outcomes.•A high-calorie, protein formula with antioxidants shows promise for efficient healing. Chronic wounds are characterized by prolonged non-healing, significantly affecting patients' quality of life. Oral formulas may enhance the wound healing process and contribute to cost reduction in care. This review aimed to evaluate the effects of oral nutritional supplementation on chronic wound healing and provide insights into formula characteristics. A comprehensive search across Cinahl, Embase, PubMed, and Web of Science databases yielded nine studies from the past decade involving 741 patients ages 52 to 81.7 across various care settings: hospitals, long-term care facilities, and home care. Primary wound types included pressure injuries (58%), diabetic foot ulcers (40%), and venous ulcers (2%). The intervention duration ranged from 2 to 16 wk, with sample sizes varying from 24 to 270 patients. Notably, four studies reported a reduction in wound area and an increased healing rate with a hypercaloric, hyperproteic formula enriched with zinc and vitamins A, C, and E. However, two studies found no significant differences compared with control groups. Two other studies investigated a combination of arginine, glutamine, and β-hydroxy-β-methylbutyrate; however, they did not yield significant results, and one study favored a hyperproteic formula instead of a hyperproteic formula with arginine. This review provides evidence supporting the potential of oral nutritional supplementation to enhance the healing process of chronic wounds. Based on our findings, a desirable formula should be characterized by a high calorie and protein content and the inclusion of antioxidant micronutrients, including, but not limited to, vitamins A, E, C, and zinc.
ISSN:0899-9007
1873-1244
1873-1244
DOI:10.1016/j.nut.2024.112449