Nutritional Support for Prevention and Treatment of Pressure Injuries in Adults: An Integrative Narrative Literature Review

Abstract

Introduction and objectives: Pressure injuries (PIs) are a significant issue for international healthcare systems. Particularly common among older adults with reduced mobility, PIs represent a considerable socio-healthcare burden, which deeply impacts the psychological well-being of patients. Malnutrition is one of the main risk factors for the development of PIs, as malnutrition hinders healing and increases the risk of complications. For these reasons, implementing appropriate nutritional interventions, often underestimated in clinical practice, is crucial to manage PIs effectively. This study primarily aimed to identify and synthesize the best scientific evidence on nutritional interventions to prevent, facilitate, or improve the healing of PIs in an adult population. Additionally, both qualitative and quantitative outcomes were analyzed.

Methods: A narrative literature review was conducted using the PubMed-Medline, Scopus, and Google Scholar databases to potentially include potential studies. The scientific validity of the study was ensured using the Scale for the Assessment of Narrative Review Articles (SANRA) and the pre-registration of the OSF database was performed using the PICOS method, which is employed in numerous studies of this type. Randomized controlled trials (RCTs) published within the last 10 years and in English were included.

Results: Out of the 1507 records identified, 8 RCTs were included, published between May 2014 and May 2023. One study focused on patient education and self-care in nutrition related to PIs, while the remaining seven focused on intensive nutritional interventions or the administration of dietary supplements to treat PIs directly. Positive therapeutic effects were observed using collagen peptides, vitamin C, and arginine. Furthermore, the topical application of fish oil showed a protective effect.

Conclusions: This study found that targeted nutritional interventions have a direct positive impact on PIs and an indirect effect on care, reducing complications and the duration of intensive care and healing times for PIs. Future systematic studies are recommended to broaden the understanding of the studied care framework.

Keywords: fragile population; nutrition; pressure injuries; public health.