Treatment with supplementary arginine, vitamin C and zinc in patients with pressure ulcers: a randomised controlled trial

Clin Nutr. 2005 Dec;24(6):979-87. doi: 10.1016/j.clnu.2005.06.011. Epub 2005 Nov 15.


Background & aims: Nutrients putatively implicated in pressure ulcer healing were evaluated in a clinical setting.

Methods: Sixteen inpatients with a stage 2, 3 or 4 pressure ulcer randomised to receive daily a standard hospital diet; a standard diet plus two high-protein/energy supplements; or a standard diet plus two high-protein/energy supplements containing additional arginine (9 g), vitamin C (500 mg) and zinc (30 mg). Nutritional status measurements (dietary, anthropometric and biochemical) and pressure ulcer size and severity (by PUSH tool; Pressure Ulcer Scale for Healing; 0=completely healed, 17=greatest severity) were measured weekly for 3 weeks.

Results: Patients' age and BMI ranges were 37-92 years and 16.4-28.1 k g/m2) respectively. Baseline PUSH scores were similar between groups (8.7+/-0.5). Only patients receiving additional arginine, vitamin C and zinc demonstrated a clinically significant improvement in pressure ulcer healing (9.4+/-1.2 vs. 2.6+/-0.6; baseline and week 3, respectively; P<0.01). All patient groups presented with low serum albumin and zinc and elevated C-reactive protein. There were no significant changes in biochemical markers, oral dietary intake or weight in any group.

Conclusions: In this small set of patients, supplementary arginine, vitamin C and zinc significantly improved the rate of pressure ulcer healing. The results need to be confirmed in a larger study.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anthropometry
  • Antioxidants / therapeutic use
  • Arginine / therapeutic use*
  • Ascorbic Acid / therapeutic use*
  • Blood Chemical Analysis
  • Dietary Supplements
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status
  • Pressure Ulcer / drug therapy*
  • Severity of Illness Index
  • Trace Elements / therapeutic use
  • Treatment Outcome
  • Wound Healing / drug effects*
  • Zinc / therapeutic use*


  • Antioxidants
  • Trace Elements
  • Arginine
  • Zinc
  • Ascorbic Acid