Complex treatment of venous leg ulcers including the use of oral nutritional supplementation: results of 12-week prospective study

Introduction
Malnutrition is known to impair the wound healing process, contributing to wound chronicity. Venous leg ulcers (VLU) represent the most common chronic leg wounds and become epidemiologically relevant in an ageing society. Aim: This study investigated the effects of a complex treatment, including a specialized oral nutritional supplementation, on the dynamics of the VLU healing.

Material and methods
This 12-week prospective study included 35 individuals with VLU. The patients received professional wound care including specialized dressings. To ensure an optimal nutritional status for wound healing, the patients were asked to drink three times per day 200 ml of an energy-dense protein-rich formula containing arginine, zinc, and vitamins. The healing dynamics were assessed by planimetry.

Results
Complete wound healing was achieved in 6 patients, and the median ulcer area decreased from 26.5 cm2 to 14.8 cm2 (p = 0.0001). Both the highest healing rates and most marked increase in prealbumin levels were observed in the first 6–8 weeks. The progress in wound healing was associated with a decreased pain intensity and an improved quality of life. Supplementation was well accepted by the patients.

Conclusions
This study shows that a complex intervention involving nutritional support contributes to a significant progress in VLU healing and promotes the well-being of affected individuals.