Pro-Stat® Indications for Use
Pro-Stat® in the treatment of pressure ulcers
Chronic ulceration of the skin remains a significant health problem especially in the aging population. At least 10% of patients in long-term health care facilities develop pressure ulcers, or bed sores.1 Many of these pressure ulcers present a challenge to the multi-disciplinary team because of their reported relationship to nutritional status.2 The Agency for Health Care Policy and Research's (AHCPR) guideline Treatment of Pressure Ulcers notes that studies have linked pressure ulcers and bed sores to malnutrition. Patients need adequate levels of protein, vitamins, and minerals to support wound healing. Inadequate caloric intake can lead to weight loss and use of protein stores for energy instead of healing. According to the AHCPR guideline, patients with pressure ulcers need 30 to 35 kilocalorie and 1.25 to 1.5 grams of protein per kilogram of body weight daily.3
Ideally, adequate protein and calories intake may be found through oral intake of food and liquids. For many elderly persons in long-term care the amount of food needed to be consumed for a positive nitrogen balance may be overwhelming. Therefore, supplementation is recommended. Supplementation of products that are high in kilocalories and volume may not be able to be tolerated by the aged. Many have decreased appetites and smaller volumes of food must be consumed throughout the day rather than large volumes at one time.
- Pro-Stat® provides the highest amount of protein in the smallest serving size (15g/30mL) making it easily tolerated by patients with limited appetites. Pro-Stat® hydrolyzed protein is available as free amino acids, polypeptide chains that are easily assimilated and immediately available to the body. Pro-Stat® is rich in the high nitrogen donor amino acids that support rapid new protein growth, tissue healing and protection of lean body mass (arginine, glycine, proline and hydorxyproline).
Observational studies on Pro-Stat® in the treatment of pressure ulcers.
Analysis - Group A - Patients with Decubiti Ulcers/Pressure Ulcers
| I.D |
Site of
Decubitus
Ulcer (d/u) |
Original
Stage
of D/U |
Response to Pro-Stat®
Recorded change in stage
and size of d/u
|
Pro-Stat®
Dose
prescribed
|
Days Fed
with
Pro-Stat®
|
Comments |
| H.A. |
Buttocks |
I |
Healed |
BID |
|
Tube feeding |
|
N.B. |
Sacrum |
I |
Healed |
OD |
|
|
|
M.L. |
Sacrum |
I |
Healed |
BID |
|
|
|
W.M |
L heel |
I |
Healed |
TID |
|
Tube feeding |
|
H.A. |
Back |
II |
Healed |
BID |
|
Albumin 2.1 |
|
L.J. |
Back |
II |
Healed |
OD |
|
|
|
W.I. |
R lat buttocks |
II |
Healed |
BID |
|
|
|
W.I. |
R med buttock |
II |
Healed |
BID |
|
|
|
W.I. |
L Buttocks |
II |
Healed |
BID |
|
|
|
C.W. |
R ear |
II |
Stage II,  in
size
|
BID |
|
|
|
L.A. |
Sacrum |
II |
Stage II, in
size |
BID |
|
|
|
M.L. |
R foot |
II |
Healed |
BID |
|
|
|
M.L. |
L foot |
II |
Healed
|
BID |
|
|
|
L.A. |
L inner heel |
II |
Stage II, in
size
|
BID |
|
Tube feeding |
|
M.M |
Sacrum |
II |
Healed |
OD |
|
|
|
S.I. |
L big toe |
II |
Healed |
BID |
|
|
|
L.K. |
R heel |
II |
Healed |
OD |
|
|
|
G.B. |
L great toe |
II |
Healed |
BID |
|
Tube feeding |
|
F.E. |
Sacrum |
II |
Stage I |
OD |
|
Redness |
|
F.E. |
L scapula |
II |
Stage II, in
size |
OD |
|
|
|
L.J. |
L lower leg |
III |
Healed |
OD |
|
|
|
M.C. |
R heel |
III |
Stage II, in
size |
BID |
|
|
|
B.S. |
Trach |
III |
Healed |
BID |
|
Albumin 1.9 |
|
Sacrum |
III |
Stage III, in
size |
BID |
|
Tube feeding |
|
W.I. |
Sacrum |
IV |
Stage IV, in
size |
BID |
|
Desirable wt |
|
S.V. |
Sacrum |
IV |
Stage IV, in
size |
TID |
|
|
|
L.A. |
Sacrum |
IV |
Stage IV, no change |
BID |
|
Albumin 1.6 |
|
S.I. |
Sacrum |
IV |
Stage IV, in
size |
BID |
|
Tube feeding |
|
S.I. |
L hip |
IV |
Stage IV,
much reduced |
BID |
|
|
|
W.M |
Sacrum |
IV |
Stage IV, in
size |
TID |
|
|
|
Data collected at
Silvercrest Extended Care,
Jamaica, NY, Reported
January 2003. |
Data Analysis - Group A
Patients with Decubiti Ulcers
There was an overall 50% reduction in the total number of
patients with Decubiti Ulcers in the Study group,
following
the Pro-Stat® therapy.
Group A - Total numbers of Decubiti Ulcer Sites
Seventeen (17) Decubiti Ulcer sites, out of a total of
thirty (30) sites, have completely healed following the
Pro-Stat® therapy.
More on pressure ulcers:
A pressure ulcer, or bed sore, is defined as any lesion caused by unrelieved pressure resulting in damage to underlying tissue. They are usually located over bony prominences are graded or staged to classify the degree of tissue damage observed. The depth of an ulcer is evaluated on a scale from I to IV. The higher the number indicated a deeper ulcer:
Pressure Ulcers Stage I - A stage I pressure ulcer, or bed sore, is an observable pressure related alteration of intact skin whose indicators as compared to the adjacent or opposite area on the body may include changes in one or more of the following: skin temperature (warmth or coolness), tissue consistency (firm or boggy feel), and/ or sensation (pain/itching. The ulcer appears as a defined area of persistent redness in lightly pigmented skin, whereas in darker skin tones, the ulcer may appear with persistent red/blue or purple hues.
Pressure Ulcers Stage II - A stage II pressure ulcer, or bed sore, is a partial thickness skin loss involving epidermis and/or dermis. The ulcer is superficial and presents clinically as an abrasion, blister, or shallow crater.
Pressure Ulcers Stage III - Stage III pressure ulcer, or bed sore, is a full thickness skin loss involving damage or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia. The ulcer presents clinically as a deep crater with or without undermining adjacent tissue.
Pressure Ulcers Stage IV - Stage IV pressure ulcer, or bed sore, is a full thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures (for example, tendon, or joint capsule).4
References
1. Michocki RJ, Lamy PP. The problem of pressure sores in a nursing home population: statistical data. J AM Geriatr Soc. 1976; 24:323-328.
2. Gilmore S, Robinson G, Posthauer M, Raymond J. Clinical indicators associated with unintentional weight loss and pressure elderly resident of nursing facilities. J Am Diet Assoc 1995; 95(9):984-92.
3. Bergstron N, Bennett MA, Carlson CE, et al. Treatment of pressure ulcers. Clinical Practice Guideline, No. 15. AHCPR Publication No. 95-0652. Rockville, Md.: Agency for Health Care Policy and Research. December 1994.
NPUAP Website:
http//npuap.org/stagingdefinition.htm.
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Indications:
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