Subnormal Prealbumin Levels and Wound Healing


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Abstract of Journal Article - August 2007  

By Peyton Barnes Jr, MD; Tiffany E. Sauter, RD, LD, CNSD; and Shirin Zaheri, BSc  

Patients with decubitus ulcers frequently have subnormal albumin and prealbumin levels; even with maximal efforts at wound healing, some of these patients' wounds prove resistant to healing. This research addresses the use of prealbumin levels as a predictor of wound healing in stages III and IV sacral and trochanteric decubitus ulcers. We hypothesized that chronically malnourished patients (ie, those with a serum albumin level of less than 3.0 mg/dL) have a certain minimum level of prealbumin below which wound healing in sacral and trochanteric decubiti is much less probable. The hypothesis is tested by an analysis of wound healing rates in patients with stages III or IV sacral or trochanteric decubitus ulcers, correlating healing rates with serum prealbumin levels. This limited study indicates that in patents with a serum albumin level of less than 3.0 mg/dL, a prealbumin level of less than 9.0 mg/dL is associated with a much lower probability of sacral or trochanteric decubitus wound healing and a significant risk of worsening of their wounds. In chronically malnourished patients, wound-healing methodologies, as opposed to wound-cleaning methodologies, may be ineffective unless serum prealbumin levels are above 9.0 mg/dL. 

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