The effect of specialized nutritional intervention with a disease-specific sip feed (Cubitan) in the support of patients with pressure ulcers.

Pressure ulcers are an increasing problem in aging Western societies and this has a significant impact on the quality of life of patients and on health economics. The prevalence ranges from 1 to 18% of in-patients and from 3 to 28% of those admitted to long-term settings. One study showed a prevalence of pressure ulcers of 10.9% out of 1431 patients in 2 Dutch hospitals. These patients were admitted to surgical, internal, neurological and/or geriatric wards between January 1999 and June 2000.

Due to the high prevalence the economic consequences are substantial, according to the Dutch Inspection of Healthcare (Inspectie voor de Gezondheidszorg) the annual costs of decubitus in 2004 were estimated to be about half a billion euros due to required intensive treatment and prolonged institutional admission. Moreover, the costs of treating pressure ulcers increase with ulcer grade, because time to heal is longer and the incidence of complications is higher in severe cases. In the UK, for example, the mean cost of treating a pressure ulcer varied from £1,064 (grade I) to £10,551 (grade IV) per patient, respectively.




Cubitan (Nutricia N.V., The Netherlands) is a Food for Special Medical Purposes (FSMP) for the dietary management of pressure ulcers. This enteral clinical nutrition sip feed is specifically designed for patients with pressure ulcers and is high in energy and protein and enriched with nutrients that are essential for pressure ulcer healing.



Although the role of nutrition is being recognised and guidelines advice nutritional supplementation for patients with pressure ulcers, nutritional supplementation is not yet part of standard (pressure ulcer) care in every setting. Conventional pressure ulcer care in this population exists of applying dressings, anti-decubitus mattresses, side-to-side turning schedules and debridement. So far, there is a paucity of well-designed trials using appropriate control groups and relevant clinical outcomes that examine the efficacy of supplemental nutrients on the healing of pressure ulcers. This study aims to investigate whether a nutritional product specifically designed to promote pressure ulcer healing will improve the rate of pressure ulcer healing in patients diagnosed with pressure ulcers stage III or IV.

Improving the rate stage III/IV pressure ulcers heal through nutritional support.

N/A

Group x: receiving standard institutional diet + daily 3 x 200 ml of Cubitan between meals for a maximum period of 8 weeks.



Group y: receiving standard institutional diet + daily 3 x 200 ml non-caloric placebo between meals for a maximum period of 8 weeks.