Cysteine/cystine-rich undenatured whey protein supplement in patients' pressure ulcers outcomes: an open label study.

Objective: The prevalence and costs associated with treating pressure ulcers (PU) are at high levels. Frequently, PUs heal slowly or not at all, which may be due to the patient's catabolic state which may include protein energy malnutrition. The objective of this open label clinical trial was to improve healing rates by providing patients with a patented, high-quality protein containing all essential amino acids to ensure positive nitrogen balance. An additional benefit of this protein is the delivery of bioavailable cysteine (cystine) to promote glutathione (GSH) synthesis which supports immune function and heightens antioxidant defences. Methods: Patients with category II, Ill and IV PUs were fed 20g BID whey protein dietary supplement for 16-120 days, without change in ongoing test practice' PU management and their progress recorded. Results: A total of 10 patients were recruited, with an average age of 77 years. Most had shown no improvement in healing for >= 2 months before treatment and usually had other complications including chronic obstructive pulmonary disease (COPD), diabetes and various cardiovascular diseases. There were a total of 23 PUs, with some patients having more than one. Of these, 44% (n=10) showed complete resolution 83% (n=19) had better than 75% resolution over the observation period. Healing rates ranged from 16.9-0.2cm(2)/month (healed PUs) and 60.0-1.6cm(2)/month for resolving PUs. Conclusion: By providing the necessary amino acids to rebuild tissues and bioactive cysteine (cystine) to promote synthesis of intracellular GSH and positive nitrogen balance, improvement in PUs healing was achieved.