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Clin Nutr. 2005 Dec;24(6):979-87. Epub 2005 Nov 15.

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

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Department of Nutrition and Dietetics, Austin Health, Studley Road, Heidelberg 3084, and School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia.



Nutrients putatively implicated in pressure ulcer healing were evaluated in a clinical setting.


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.


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.


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.

[Indexed for MEDLINE]

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