Q: Should nursing home residents with pressure ulcers be given additional vitamin C and zinc supplements to promote healing?
A: Vitamin C (ascorbic acid) is required by the body for wound healing as a cofactor in collagen formation and fibroblast function. Deficiencies of vitamin C can result in delayed wound healing, capillary fragility, breakdown of old wounds, lowered threshold for pressure-induced injury, and an impaired immune function.
Symptoms of vitamin C deficiency (also known as scurvy) may include: anemia, weight loss, muscle and joint aches, bleeding that may occur under the skin (particularly around hair follicles or as bruises), swollen purple or bleeding gums, dry brittle hair, and dry scaly skin. The inclusion of fruits and vegetables such as citrus fruits in the diet can achieve the desired recommended daily amount. Research shows that mega doses of vitamin C do not accelerate wound healing.
Meanwhile, the benefits of zinc to the body are numerous: Zinc is a mineral that functions as an antioxidant and is associated with collagen formation, synthesis of protein, DNA and RNA, and cell proliferation. Signs of zinc deficiency include hair loss, diarrhea, poor appetite, decreased sense of taste and smell, and lesions in the skin and eyes.
Easily recognized signs that may be caused by zinc deficiency are white spots, bands or lines on fingernails (symptoms of leukonychia). Zinc deficiency is rare. Good sources of zinc include high protein foods such as meat, liver, and shellfish. No research has demonstrated an effect of zinc supplementation on improved pressure ulcer healing.
If a resident’s dietary intake is poor or there is evidence of vitamin deficiency, it is recommended to offer a multivitamin with minerals supplement daily.
Please send your wound treatment-related questions to Donna Sardina at [email protected].
From the December 01, 2010 Issue of McKnight's Long-Term Care News
