Comparative Analysis of Two Arginine-Glutamine Based Nutritional Supplements for Wound Healing in Newly Spinal Cord Injured Acute Rehab Patients

Purpose: To determine the difference, if any, between the two commercially available arginine-glutamine based nutritional supplements, on the rate of wound healing and nutritional status in newly spinal cord injured (SCI) acute rehab patients.

Subjects: Newly SCI adult patients (age = 21-70y) admitted to an inpatient acute rehab hospital over a 4 month period who present with a stage 3 or stage 4 coccygeal pressure ulcer as assessed by a Certified Wound Ostomy Continence Nurse and with given written consent for study participation.

Method: Subjects (n=20) were randomized by date and time of admission to one of two groups, AGWPV or AGHMB and given 2 servings a day of an arginine-glutamine based oral supplement for a 4 week period.  Group AGWPV (n=10) received a supplement containing 140 calories with arginine(7g),  glutamine(7g),  whey protein(10g),  carbohydrate(10.75g), trans-galactooligosaccharide(2.75g), vitamin C(250mg), copper(1mg), zinc(12.5mg) and sucralose.  Group AGHMB (n=10) received a supplement containing 78 calories with arginine(7g),  glutamine(7g), carbohydrate(7.7g), ß-hydroxy ß-methylbutyrate(HMB)(1.2g) and aspartame. Both groups also received a powdered therapeutic multi-vitamin and mineral supplement and regular textured hospital prepared meals.Results: Baseline and weekly Pressure Ulcer Scale for Healing (PUSH) score and body weight. Baseline and week 4 serum albumin, prealbumin, blood urea nitrogen, creatinine, potassium and sodium. Conclusion:  We anticipate that newly SCI patients with advanced staged pressure ulcers who receive an arginine-glutamine based oral supplement augmented with whey protein, a pre-biotic, and anti-oxidants will demonstrate increased rate of wound healing and improved nutritional status as compared to those receiving an arginine-glutamine based oral supplement augmented with only HMB.