Nutritional treatment of pressure ulcers: what is the evidence?

To review the literature on the nutritional treatment of pressure ulcers, with an emphasis on long-term care issues. The focus is on studies that have used high energy or high protein diets, supplementation with vitamin C, zinc, or arginine, or some combination of those four approaches. The goal of this review is to clarify the evidence (if any) supporting each nutritional treatment.

A search of the literature was conducted including PubMed, CINAHL, and MEDLINE. Search terms included "pressure ulcers," in combination with "treatment," "nutrition," "supplements," "Vitamin C," "zinc," and "arginine."

Studies of high energy and high protein intake provide some evidence that those may be useful interventions, but the evidence is not strong. Although we have basic science providing evidence of the role of vitamin C, zinc, and arginine in wound healing processes, data on those nutrients related to pressure ulcer healing is equivocal.

Nurse practitioners should assess the nutritional status of patients with pressure ulcers and treat deficiencies within current guidelines. At this time, there is not strong evidence to support the use of specific nutritional supplements.