The Ultimate Formula for Advanced Wound Care

New Citrus Splash

n Clinically proven n 17 grams of complete & 108 calories in 1 oz with added , Vitamin C, Zinc, and Citrulline for optimal wound healing n The only wound care formula with the Citrulline Advantage n Hydrolyzed protein for rapid absorption & utilization n Ready-to-drink

Medical Nutrition USA Inc. is now part of Nutricia, a global leader in medical nutrition. Wound Healing Requires Additional Protein, Calories, Vitamins, Minerals, & Amino Acids

Pro-Stat® Advanced Wound Care (AWC) provides these nutrients all in 1 oz to increase compliance

Protein n Essential for the maintenance & repair of body tissue, (17 g) building Lean Body Mass (LBM)

Calories n Energy source to preserve LBM (108 kcal)

Arginine n Only producer of Nitric Oxide, which increases blood (3.3 g) flow to wound & supports collagen formation

Citrulline n Precursor to Arginine, increasing Nitric Oxide production (300 mg)

Vitamin C n Essential for connective tissue & collagen synthesis, supports formation (175 mg) of new blood vessels & wound strength

Zinc n Essential for DNA synthesis, cell division, collagen & protein synthesis, (10 mg) and immunity, all necessary for regeneration & repair

The only formula with the Citrulline Advantage Citrulline is an that raises plasma Arginine levels more efficiently than supplemental Arginine, increasing its availability for conversion to nitric oxide to accelerate wound healing1-6

Fact: • Nitric Oxide increases blood flow & oxygen delivery to wounds, increases collagen formation & 7-13 cross linking, and kills bacteria Situation: • Arginine is the only producer of Nitric Oxide14. Demands for Arginine increase in the presence of 15-17 a wound, however 40% of ingested Arginine is broken down in the intestine & liver Solution: • Citrulline, unlike Arginine, bypasses intestinal & liver breakdown & converts to Arginine for more efficient Nitric Oxide production18-20

Citrulline Arginine Nitric Oxide = Accelerated Wound Healing

1.Morris SM. Annu Rev Nutrition 1992.2.Curis E et al. Amino Acids 2005. 3.Wu GY, Brosnan JT. Biochem J 1992.4.Schwedhelm E, et al. Br J Clin Pharmacol 2008. 5.Waugh WH et al. Am J Haematol 1999.6.Waugh WH et al. J Natl Med Ass 2001.7.Witte MB et al. World J of Surgery 2004. 8.Witte MB et al. The American J of Surgery 2002.9.Luo J, Chen A. Acta Pharmacological Sinica 2005.10.Childress BB, Stechmiller JK. Biological Research for Nursing 2002.11.Isenberg R et al. Microsurgery 2005. 12.Schwentker A, Billiar TR. The Surgical Clinics of North America 2003.13.Witte MB et al. Surgical Forum 1997.14.Efron DT et al. Curr Opin Clin Nutr Metab Care 2000. 15.Castillo L et al. Am. J. Physiol 1993a. 16.Wu G. J Nutrition 1998.17. Morris SM. J Nutrition 2004.18.Wu G. Biochem J 1998.19.Windmueller HG, Spaeth AE. Am J Physiol Endocrinol Metab 1981.20.Osowska S et al. Gut 2004. For the Optimum in Nutrition Support:

Recommend Pro-Stat Advanced Wound Care (AWC) for Stage 3 & 4 Pressure Ulcers and Hard-to-Heal Wounds

Pro-Stat® AWC Juven®* Arginaid®*

Serving Size 1 oz 1 packet mixed with 8 fl oz 1 packet mixed with 6-8 fl oz Complete Protein** 17 g** 0** 0** Calories 108 k/cal 70-80 k/cal 35 k/cal Arginine 3.3 g 7 g 4.5 g Zinc 10 mg 0 0 Vitamin C 175 mg 0 155 mg Citrulline 300 mg 0 0 Glutamine/ 1.68 g 7 g 0 Calcium β-hydroxy-β-methylbutyrate 0 1.5 g 0 Cystine 60 mg 0 0 Glycine 4 g 0 0 Proline 2.2 g 0 0 Hydroxyproline 2.1 g 0 0

Recommended Daily Intake 1 oz three times a day 8 oz two times a day 8 oz two times a day 3 oz 16 oz 16 oz

one ounce

**Evidence based guidelines recommend 1.2-1.5 grams of protein per kg of body weight for prevention and treatment of wounds1. Depleted protein levels will cause a decrease in collagen formation, slowing the wound healing process. Adequate protein levels will help achieve optimal wound healing rates.

*Juven is a registered trademark of Abbott Nutrition, Arginaid is a registered trademark of Nestle Nutrition 1.Dorner B, Posthauer ME, Thomas D; National Pressure Ulcer Advisory Panel. The role of nutrition in pressure ulcer prevention and treatment: National Pressure Ulcer Advisory Panel white paper. Adv Skin Wound Care. 2009;22:212-221. Pro-Stat® Advanced Wound Care Clinically shown to improve chronic wound healing

n Use of Pro-Stat AWC resulted in 41% Improvement in PUSH Scores*

20 n Before Pro-Stat 15 n On Pro-Stat AWC with Citrulline (1oz TID) 10 for seven weeks

PUSH Scores 5

0 1 2 3 4 5 6 7 8 9 10 Resident with Chronic Wound

Main Features: Pro-Stat® AWC with Citrulline • Patented and Clinically Proven Nutrition Facts Typical Amino Acid Composition • Hydrolyzed for rapid absorption & efficient utilization Serving Size: 30 ml (2 tablespoons) (g/100 g of protein) • Fortified with specialized nutrients for advanced wounds Servings per Container: 30 Essential Amino Acids • The only wound care supplement with Citrulline 0.74 • 2 Amount Per Serving % Daily Value† Isoleucine 1.70 Indications: Calories 108 Leucine 3.10 Lysine 4.50 • Stage 3 & 4 pressure ulcers Calories from Fat 0 Methionine 0.80 • Multiple pressure ulcers Total Carbohydrate 10.2 g 3% Phenylalanine 2.20 • Hard to heal wounds (including diabetic, venous, Threonine 2.20 surgical, burns) Sugar 10.2 g ** 0.44 Ingredients: Hydrolyzed Kosher Collagen Protein, Xylitol (Sugar Alcohol) <1 g ** Valine 2.60 Purified Water, Fructose, L-Arginine, Citric Acid, Non-Essential Amino Acids L-Citrulline, Xylitol, Natural Flavors, Vitamin C, L-Tryptophan, Total Protein 17 g 34% Alanine 9.30 Sodium Benzoate, Potassium Sorbate, Phosphoric Acid, (Includes L-Arginine 3.3 g) Aspartic Acid 6.60 L-Cystine,Glycerin, Zinc Sulfate, Sucralose, Potassium Serine 3.20 Citrate, Sodium Phosphate, Neotame. Ascorbic Acid (Vitamin C) 175 mg 290% Conditionally-Essential Amino Acids Lactose Free, Gluten Free, Soy Free. Zinc 10 mg 67% Arginine 21.75 Cystine 0.33 Osmolality: 685 mOsm/kg water Sodium 13 mg <1% Glutamic Acid 11.10 Viscosity: Honey- like Glycine 26.90 Use orally or with tube feeding. Potassium 17 mg <1% Proline 14.80 Pro-Stat® Advanced Wound Care is a medical food. Phosphorus 13 mg 1.3% Tyrosine 0.20 Use under medical supervision. Modified Amino Acids † Manufactured under U.S. Patents: Method for Treating Wounds to Promote Healing Percent Daily Values are based on a 2,000 -calorie diet. Hydroxylysine 0.91 (No. 7,318,934), Method for Treating Decubitus Ulcers (No. 7,682,624), Method for **Daily Values(DV) not established. Hydroxyproline 14.00 Treating Hypoalbuminemia (No. 7,682,625).

® Pro-Stat AWC with Citrulline for Advanced Wound Care New Citrus Splash Size Item Flavor Case Pack HCPCS NDCF # Flavor Bottles (887 ml - 30 oz.) 40130 Wild Cherry Punch 4/30 oz. B4155 26974-0410-30 Packets (30 ml - one oz) 40130-U Wild Cherry Punch 96 x one oz B4155 26974-0410-31 Bottles (887 ml - 30 oz.) 40230 New Citrus Splash 4/30 oz. B4155 26974-0410-23 Packets (30 ml - one oz) 40230-U New Citrus Splash 96 x one oz B4155 26974-0410-24

Call 1-800-221-0308 for a Free Sample and Information. www.pro-stat.com Medical Nutrition USA Inc. is now part of Nutricia, a global leader in medical nutrition.