The clinical practice guidelines regarding the prevention and treatment of pressure ulcers developed by the Consortium of Spinal Cord Medicine, based on the scientific literature published from 1966 - 1998, suggest regular assessment of nutritional status with attention to risk factors associated with the development of pressure ulcers, the provision of adequate nutritional intake, and the implementation of aggressive nutritional support measures if indicated.  Three studies, which have been published since that time, reported associations between reduced pressure ulcer development and higher levels of serum total protein, albumin, prealbumin, zinc, and vitamin A.  In addition, two studies reported that pressure ulcer development was least likely to occur among spinal cord-injured individuals who maintained a normal weight and demonstrated other protective behaviors related to diet, exercise and lifestyle.      

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.