Table 29Clinical evidence profile: 500kcal 21g protein, 0g fat, 500mg vitamin C, 30mg zinc, 9g of arginine and standard hospital diet versus 500kcal 18g protein, 0g fat, 72mg vitamin C and 7.5mg zinc and standard hospital diet

Quality assessmentNo of patientsEffectQualityImportance
No of studiesDesignRisk of biasInconsistencyIndirectnessImprecisionOther500kcal 21g protein, 0g fat, 500mg vitamin C, 30mg zinc, 9g of arginine and standard hospital diet500kcal 18g protein, 0g fat, 72mg vitamin C and 7.5mg zinc and standard hospital dietRelative (95% CI)Absolute
PUSH scores at week 3 (0=complete healing, 17=greatest severity) (final scores) – elderly adults or people with a spinal injury, stage 2, 3 or 4 ulcersc(unclear if nutritionally deficient)54
1Randomised trialVery seriousaNo serious inconsistencyNo serious indirectnessNo serious imprecisionSeriousb2.6 (s.d 0.6)
n=5		6 (s.d 1.2)
n=5		-MD 3.4 lower (4.58 to 2.22 lower)Very lowCritical
Proportion of people with pressure ulcers completely healed
-------------
Time to complete healing of pressure ulcers
-------------
Reduction in size or volume of pressure ulcers
-------------
Rate of reduction in size or volume of pressure ulcers
-------------
Pain (wound-related)
-------------
Time in hospital
-------------
Patient acceptability of supplements
-------------
Side effects (nausea, vomiting, diarrhoea)
-------------
Mortality (all-cause)
-------------
Health-related quality of life
-------------
a

Desneves (2005) did not provide details of allocation concealment or blinding of participants or those administering treatment. However outcome assessors were blinded.

b

The between-group comparisons were evaluated using the Mann-Whitney U-test but no log transformations conducted.

c

Australian Wound Management Association Clinical Practice Guidelines classification of pressure ulcers.

From: 5, Nutrition and hydration

Cover of The Prevention and Management of Pressure Ulcers in Primary and Secondary Care
The Prevention and Management of Pressure Ulcers in Primary and Secondary Care.
NICE Clinical Guidelines, No. 179.
National Clinical Guideline Centre (UK).
Copyright © National Clinical Guideline Centre, 2014.

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