DİYABETİK AYAK ÜLSERİ TANISI İLE NEGATİF BASINÇLI YARA TEDAVİSİ UYGULANAN HASTALARA VERİLEN ORAL BESLENME TAKVİYESİNİN BESLENME DURUMU VE YARA İYİLEŞMESİ ÜZERİNE ETKİSİ

Abstract

Medical nutrition therapy practices’ efficacy on diabetes complications is could not been fully proven. In this study, the potential contributions of wound specific oral nutritional supplement to improve nutritional status, inflammation levels and heal foot wounds in patients with diabetic foot ulcer were investigated. The study was carried out on patients with diabetic foot ulcers who received negative pressure wound treatment at Ankara University Faculty of Medicine, Department of Peripheral Vascular Surgery, General Surgery Wound Care Unit. A total of 25 patients participated, there were 21 male and 4 female patients. Patients’ duration of diabetes was between 6-46 years, and their age range was 40-80 years. The patients were divided into two groups as control (n=12) and intervention group (n=13), food consumption records were followed up during four weeks on daily basis. Diabetes-compatible medical nutrition therapy had energy between 1496,9-2266,8 kcal/day was planned for patients. While the control group received only diabetic medical nutrition therapy, the intervention group received wound-specific nutritional supplement containing 14,8 g arginine, 14,8 g glutamine, and 2,6 g hydroxy-methyl-butyrate, in addition to diabetic medical nutrition therapy. Although there was no statistically significant difference in terms of energy and other macronutrient intake amounts between groups, intervention group’s protein intake levels were elevated significantly (p<0.05). In the control group, a statistically significant difference was found between albumin levels before and after medical nutrition therapy (p<0.05), and this difference was nearly significant in C-Reactive protein (CRP) levels (p=0.05-0.10). On the other hand, in the intervention group there was a statistically significant difference between CRP, hemoglobin, hematocrit and sedimentation values measured before and after medical nutrition therapy (p<0.05). Also the difference was found to be nearly significant for leukocytes, thrombocyte and Interleukin-6 values in the intervention group before and after the medical nutrition therapy (p=0.05-0.10). Calculated differences between before and after medical nutrition therapy for albumin, hematocrit and sedimentation were found to be significant between groups (p<0,05). Wound assessment scores were found to decrease in both groups before and after medical nutrition therapy and showed a significant difference in both control and intervention groups (p<0.05). Wound size measures also found to decrease in both groups, but the difference found to be statistically significant for only control group before and after medical nutrition therapy (p<0.05). Wound assessment scores’ calculated difference between before and after medical nutrition therapy were found to be nearly significant between groups (p=0,05-0,10). These results point out that wound specific oral nutritional supplement may contribute to wound healing by regulating some inflammation indicators in diabetic foot patients.