Sixteen inpatients (37-92 years) with a stage 2, 3, or 4 pressure ulcer were randomly assigned to receive a standard hospital diet (n = 6); a standard diet plus a protein/energy supplement (n = 5); or a standard diet plus a protein/energy supplement providing additional arginine (9 g/day), vitamin C (500 mg/day) and zinc (30 mg/day) (n = 5) for three weeks. Only patients receiving additional arginine, vitamin C, and zinc demonstrated clinically significant ulcer healing (mean improvement, 73%), and the degree of improvement was significantly greater after three weeks in that group than in the other two groups (p < 0.05).

Comment: While malnutrition is common in patients with chronic pressure ulcers, studies evaluating the effects of individual nutrients (such as vitamin C or zinc) have produced equivocal results. In the present study, a clear beneficial effect was observed with a supplement that included three nutrients that play a role in wound healing. Other nutrients that are important for wound healing include protein, B vitamins, copper, and vitamin A.

Desneves KJ, et al. Treatment with supplementary arginine, vitamin C and zinc in patients with pressure ulcers: a randomised controlled trial. Clin Nutr. 2005;24:979-987.