Résumé
EPUAP recommande que l’évaluation de l’état nutritionnel
intègre au moins un suivi régulier du poids des patients,
une évaluation de l’état de la peau et une documentation
des apports nutritionnels et hydriques. Des procédures supplémentaires
incluant des mesures anthropométriques et des tests biologiques peuvent
aussi être effectuées, même si elles peuvent être
considérées comme des techniques d’évaluation
plus sophistiquées. L’intervention nutritionnelle doit se concentrer
sur l’amélioration des apports nutritionnels et hydriques,
en tenant compte de la qualité de ces apports et de la suppression
des obstacles physiques ou sociaux à leur consommation. Une supplémentation
nutritionnelle peut être envisagée lorsque qu’il n’est
pas possible d’augmenter les apports.
Les Références utilisées pour la réalisation
de ces recommandations
American Society for Parenteral and Enteral Nutrition Board of Directors.
Definition of terms used in ASPEN guidelines and standards. JPEN 1995;
19: 1–2.
Benati G, Delvecchio S, Cilla D, and Pedone V. Impact on pressure ulcer
healing of an arginine enriched nutritional solution in patients with
severe cognitive impairment. Arch Gerontol Geriatr, 2001, 33 Suppl 1,
43–47.
Bourdel-Marchasson I, Barateau M, Rondeau V, Dequae-Merchadou L, Salles-Montaudon
N, Emeriau JP, Manciet G, and Dartigues JF. A multicenter trial of the
effects of oral nutritional supplementation in critically ill older inpatients.
GAGE Group.
Groupe Aquitain Geriatrique d’Evaluation. Nutrition, 2000, 16(1),
1–5.
Breslow RA, Hallfrisch J, Guy DG, Crawley B, and Goldberg AP. The importance
of dietary protein in healing pressure ulcers. J Am Geriatr Soc, 1993,
41(4), 357–362.
Chernoff RS, Milton KY, and Lipschitz DA. The effect of a very high protein
liquid formula on decubitus ulcers healing in longterm tubefed institutionalised
patients. J Am Diet Assoc,1990, 90, A–130.
Delmi M, Rapin CH, Bengoa JM, Delmas PD, Vasey H, and Bonjour JP. Dietary
supplementation in elderly patients with fractured neck of the femur.
Lancet, 1990, 335(8696), 1013–1016.
Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson
RA, and Jeejeebhoy KN. What is subjective global assessment of nutritional
status? J. Parenter. Enteral Nutr., 1987, 11: 8–13
Gray-Donald K, Payette H, and Boutier V. Randomized clinical trial of
nutritional supplementation shows little effect on nutritional status
among free-living frail elderly. J Nutr 1995; 125(12): 2965–71.
Green CJ. Existence, causes and consequences of disease related malnutrition
in the hospital and the community, and clinical and financial benefits
of nutritional intervention. Clinical Nutrition 1999; 18(Supp 2): 3–28.
Keele AM, Bray MJ, Emery PW et al. Two phase randomized controlled clinical
trial of postoperative oral dietary supplements in surgical patients.
Gut 1997; 40: 393–399.
Langer G, Schloemer G, Knerr A, Kuss O, and Behrens J. Nutritional interventions
for preventing and treating pressure ulcers (Cochrane Review). In: The
Cochrane Library, Issue 4, 2003. Chichester, UK: John Wiley & Sons,
Ltd.
Lipschitz DA, Mitchell CO, Steele RW et al. Nutritional evaluation and
supplementation of elderly subjects participating in a ‘meals on
wheels’ programme. JPEN 1985; 9: 343–347.
Mathus-Vliegen EMH. Nutritional status, Nutrition and Pressure Ulcers.
Nutrition in Clinical Practice 2001; 16: 286–291.
Norris JR and Reynolds RE. The effect of oral zinc sulfate therapy on
decubitus ulcers. J Am Geriatr Soc, 1971, 19,
793–797.
Robinson G, Goldstein M, and Levine GM. Impact of nutritional status on
DRG length stay. JPEN 1987; 11: 49–52.
Taylor TV, Rimmer S, Day B, Butcher J, and Dymock IW. Ascorbic acid supplementation
in the treatment of pressuresores. Lancet, 1974, 2(7880), 544–546.
ter Riet G, Kessels AG, and Knipschild PG. Randomized clinical trial of
ascorbic acid in the treatment of pressure ulcers. J
Clin Epidemiol, 1995, 48(12), 1453–1460.
The EPUAP would suggest that a sound starting point for further exploration
of the links between nutrition and pressure ulcers would be the publication:
Mathus-Vliegen EMH. Nutritional status, Nutrition and Pressure Ulcers.
Nutrition in Clinical Practice 2001; 16: 286–291.
Texte préparé par Michael Clark pour le
groupe de travail sur les recommandations, 16 Novembre 2003.
Published
in 2003.
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