Ye J, Mani R, et al.
The international journal of lower extremity wounds. Date of publication 2016 Dec 1;volume 15(4):296-302.
1. Int J Low Extrem Wounds. 2016 Dec;15(4):296-302. doi: 10.1177/1534734616674624.
Epub 2016 Nov 3.
A Systematic Review and Meta-Analysis of Nutritional Supplementation in Chronic
Lower Extremity Wounds.
Ye J(1)(2), Mani R(2)(3)(4).
Author information:
(1)1 Ruijin Hospital, Shanghai, China.
(2)2 Shanghai Jiao Tong University, Shanghai, China.
(3)3 University of Southampton, Southampton, UK.
(4)4 Chiang Mai University, Chiang Mai, Thailand.
A systematic review and meta-analyses of nutritional supplementation to treat
chronic lower extremity wounds was done in order to test the premise that
impaired nutrition is implicated in healing. The databases of Ovid MEDLINE, Ovid
EMBASE, Cochrane Library, and EBSCO CINAHL (1972-October 2014) were searched
systematically. Only randomized controlled trials in adults with chronic lower
extremity wounds were included. Both topical and systemic routes of supplementing
nutrition were considered. The primary outcome was wound healing. Study
characteristics, outcomes, and risk of bias were extracted by trained researchers
and confirmed by the principal investigator. Twenty-three of 278 (8.3%) retrieved
articles met the inclusion criteria and were selected. Most of the studies were
of unclear or low risk. Overall, nutritional supplementation was favorable (risk
ratio [RR] = 1.44, 95% confidence interval [CI] = 1.25-1.66). The systemic route
was marginally better than the topical one (RR = 1.51, 95% CI = 1.36-1.67; RR =
1.14, 95% CI = 0.96-1.36, respectively). For venous ulcers, the data showed
nutritional supplementation to be significantly beneficial compared to placebo
(RR = 1.44, 95% CI = 1.31-1.59). Similar data were found for diabetic foot and
sickle cell ulcers (RR = 1.17, 95% CI = 0.93-1.47; RR = 1.56, 95% CI = 0.94-2.60,
respectively). These data permit the inferences that nutritional supplementation
in the populations studied showed significant benefits in the healing of venous
ulcers and tendency (nonsignificant trends) in the healing of diabetic and sickle
cell ulcers.
DOI: 10.1177/1534734616674624
PMID: 27810941 [Indexed for MEDLINE]
