Remedy Publications LLC., | http://clinicsinsurgery.com/ Clinics in Surgery 2019 | Volume 4 | Article 2353 1 Collagen Peptide as an Effector in Pressure Injuries Treatment in Older Adult Inpatients OPEN ACCESS *Correspondence: Teruyoshi Amagai, School of Human Environmental Sciences, Mukogawa Women's University, Nishinomiya, 663- 8558, Japan, E-mail: amagait@nutrped.com Received Date: 29 Jan 2019 Accepted Date: 01 Mar 2019 Published Date: 05 Mar 2019 Citation: Hokotachi Y, Itoh M, Akasaki M, Kai C, Hasegawa M, Tamura T, et al. Collagen Peptide as an Effector in Pressure Injuries Treatment in Older Adult Inpatients. Clin Surg. 2019; 4: 2353. Copyright © 2019 Teruyoshi Amagai. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Research Article Published: 05 Mar, 2019 Abs t ract Aim: To examine the hypothesis that Collagen Peptide (CP) is efective in the treatment of Pressure Injuries (PI) in older adult inpatients. Methods: Tis study was a retrospective chart review conducted at a single institution. All consecutive patients who developed PI before or afer admission to a single institution between January 2013 and September 2015 were enrolled. Data collected were: 1) characteristics; 2) blood test, CRP, and serum Alb during the period of PI treatment (PPT); 3) PI, evaluated by the DESIGN-R scoring system; 4) nutrition, body weight, BMI at baseline, and energy and protein intake during PPT; and 5) outcomes, the change in DESIGN-R score during PPT (ΔD), ΔD/PPT. Subjects were divided into two groups: with or without CP supplement. All collected data were compared for PI patients in Method 1: PPT ≤ 28 days vs. >28 days and Method 2: PPT ≤ 28 days treated with CP vs. non-CP. Results: Among 2,245 included patients, the prevalence of PI and incidence of hospital-acquired PI were 2.93% and 1.69%, respectively. Result 1: PI patients with PPT ≤ vs. >28 days had the following characteristics: ≥ 89 years old, lower Alb, and a less severe PI expressed as a DESIGN-R score <10. Te outcomes, expressed as PPT/ΔD and ΔD/PPT, were also signifcantly better. Result 2: the CP- group had a more severe PI and, paradoxically, a signifcantly lower Alb and Hb at baseline. Conclusion: From our results, two conclusions were drawn: (1) PI inpatients who healed within 28 days were ≥ 89 years old, had a lower Alb, and had better outcomes, expressed by a signifcantly shorter PPT/ΔD. (2) PI inpatients treated with CP, who had a more severe PI and, paradoxically, a signifcantly lower Alb and Hb at baseline, healed within 28 days. In conclusion, CP could be a strategic agent for PI treatment for inpatients ≥ 89 years old, a lower Alb and Hb, and a DESIGN-R score <10 at baseline. Keywords: Pressure injury; Collagen peptide; Albumin; DESIGN-R Yoko Hokotachi 1,2 , Masako Itoh 3 , Masumi Akasaki 3 , Chiho Kai 1,4 , Mari Hasegawa 5 , Toshihide Tamura 3 , Satoshi Uramoto 3 and Teruyoshi Amagai 5 * 1 Administration Food Sciences and Nutrition Major, Graduate School of Human Environmental Sciences, Mukogawa Women's University, Japan 2 Department of Clinical Nutrition, Takarazuka Dai-ichi Hospital, Japan 3 Kikai Tokushukai Hospital, Japan 4 Department of Clinical Nutrition, Higashi Kobe Hospital, Japan 5 School of Human Environmental Sciences, Mukogawa Women's University, Japan Introduction Older adult inpatients have multifactorial comorbidities, medications, and/or physical impairments, leaving them at high risk of pressure injuries. Tese factors might confer a risk of immobility, due not only to organ-localized functional impairments of bone, muscle, or articular lesions, but also to systemic functional impairments in mental and cardiopulmonary functions and/ or perfusion. All these factors have the potential to result in the development of a Pressure Injury (PI). PI is both a physical and a socio-economic burden. In particular, treatment of PI in older patients requires a multifactorial strategy that includes a local dressing and cleansing treatment and general repositioning, early mobilization, and nutrition care [1]. In addition, guidelines state that supplementation with a solution containing 61 g protein per liter (24 energy percent) was more successful in decreasing total pressure injury area than a formula with 37 g protein per liter (14 energy percent) in a geriatric population [2]. One interpretation of this fnding is that nutritional support is efective when patients are malnourished. Tese guidelines also recommend treatment with energy of 30 to 35 kcal/kg body weight-1 day-1 and 1.25 g to 1.5 g protein/kg body weight-1