Treatment of Pressure Ulcers
Authors: Thomas E. Finucane
Journal: Annals of Internal Medicine (2015)

Letters20 October 2015Treatment of Pressure UlcersThomas E. Finucane, MDThomas E. Finucane, MDFrom Johns Hopkins School of Medicine, Baltimore, Maryland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5148-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Qaseem and colleagues' first recommendation in their guideline on pressure ulcer treatment (1) is that “clinicians use protein or amino acid supplementation in patients with pressure ulcers to reduce wound size.” They note that “evidence for the optimal dose or form of protein was insufficient.”Of the 14 cited studies, 5 focus on arginine supplementation and 1 each on a proprietary formulation; a collagen protein hydrolysate; and ornithine α-ketoglutarate, presumably the recommended amino acid supplementation. Of the 5 studies of arginine, that of Benati and associates (n = 16; 3 groups; duration, 2 weeks) (2) provides no statistics. ...References1. Qaseem A, Humphrey LL, Forciea MA, Starkey M, Denberg TD; Clinical Guidelines Committee of the American College of Physicians. Treatment of pressure ulcers: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2015;162:370-9. [PMID: 25732279] doi:10.7326/M14-1568 LinkGoogle Scholar2. Benati G, Delvecchio S, Cilla D, Pedone V. Impact on pressure ulcer healing of an arginine-enriched nutritional solution in patients with severe cognitive impairment. Arch Gerontol Geriatr Suppl. 2001;7:43-7. [PMID: 11431045] CrossrefMedlineGoogle Scholar3. Brewer S, Desneves K, Pearce L, Mills K, Dunn L, Brown D, et al. Effect of an arginine-containing nutritional supplement on pressure ulcer healing in community spinal patients. J Wound Care. 2010;19:311-6. [PMID: 20616774] CrossrefMedlineGoogle Scholar4. Desneves KJ, Todorovic BE, Cassar A, Crowe TC. Treatment with supplementary arginine, vitamin C and zinc in patients with pressure ulcers: a randomised controlled trial. Clin Nutr. 2005;24:979-87. [PMID: 16297506] CrossrefMedlineGoogle Scholar5. Meaume S, Kerihuel JC, Constans T, Teot L, Lerebours E, Kern J, et al. Efficacy and safety of ornithine alpha-ketoglutarate in heel pressure ulcers in elderly patients: results of a randomized controlled trial. J Nutr Health Aging. 2009;13:623-30. [PMID: 19621198] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Johns Hopkins School of Medicine, Baltimore, Maryland.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=L15-0418. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTreatment of Pressure Ulcers: A Clinical Practice Guideline From the American College of Physicians Amir Qaseem , Linda L. Humphrey , Mary Ann Forciea , Melissa Starkey , Thomas D. Denberg , and Treatment of Pressure Ulcers Emanuele Cereda Treatment of Pressure Ulcers Jill Monfre and Justin Endo Treatment of Pressure Ulcers Janet E. Cuddigan , Jan Kottner , Emily Haesler , and Treatment of Pressure Ulcers Mary Ann Forciea , Linda L. Humphrey , and Amir Qaseem Treatment of Pressure Ulcers Emanuele Cereda Treatment of Pressure Ulcers Mary Ann Forciea , Linda L. Humphrey , and Amir Qaseem Treatment of Pressure Ulcers Jill Monfre and Justin Endo Treatment of Pressure Ulcers Janet E. Cuddigan , Jan Kottner , Emily Haesler , and Metrics 20 October 2015Volume 163, Issue 8Page: 647KeywordsAmino acidsArginineConflicts of interestDisclosurePressure ulcersProteinsTreatment guidelines ePublished: 20 October 2015 Issue Published: 20 October 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...