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Effects and associations of nutrition in patients with venous leg ulcers: A systematic review
Author(s) -
Barber Georgina A,
Weller Carolina D,
Gibson Simone J
Publication year - 2018
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.13474
Subject(s) - medicine , cinahl , medline , overweight , cochrane library , psychological intervention , systematic review , etiology , micronutrient , body mass index , physical therapy , intensive care medicine , surgery , meta analysis , pathology , nursing , political science , law
Abstract Aims To identify the associations and effects of nutritional characteristics and interventions on ulcer outcomes in adult patients with venous leg ulcers. Background Venous leg ulcers are the most prevalent type of lower limb ulcer; however, little evidence exists regarding the relationship between nutritional status and ulcer healing. Design A systematic search of English language articles was conducted using the Cochrane Collaboration Handbook for Systematic Reviews of Interventions. Data sources A search of databases Ovid MEDLINE , EMBASE , Cochrane, CINAHL and Scopus was performed for studies published between January 2004 ‐ May 2017. Review methods Quality of the included studies was assessed using the Cochrane Collaboration's Risk of Bias Assessment tool and the relevant Joanna Briggs Institute quality appraisal checklists. Results Twenty studies met the inclusion criteria. All participants had Clinical Aetiology Anatomy Pathophysiology classification C5 (healed) or C6 (active) ulcers. Studies were conducted in a range of clinical settings with relatively small sample sizes. The majority of patients were overweight or obese. Increased body mass index was associated with delayed wound healing. Vitamin D, folic acid and flavonoids were associated with some beneficial effects on ulcer healing. Dietary intakes of omega‐3 fatty acids, vitamin C and zinc were low for some patients. Conclusion Current evidence suggests that venous leg ulcer patients are more likely to be overweight or obese. However, evidence for weight management improving wound healing is lacking. Micronutrients, including vitamin D and folic acid, may improve wound healing in at‐risk patients.