The Potential Role of Zinc Supplementation on Pressure Injury Healing in Older Adults

A Review of the Literature

Melissa Heintschel, MS, RD, LD; Roschelle Heuberger, PhD, RD


Wounds. 2017;29(2):56-61. 

In This Article


A total of 10 studies were analyzed and evaluated. These findings include 4 observational studies[25–28] and 6 clinical trials[29–34] (eTable 1 and eTable 2, respectively). Outcome assessments were analyzed including nutritional status, Zn biomarkers, micronutrient measurement in wound exudate, and PI healing. These findings included Braden Pressure Ulcer Risk Assessment Score (BPURAS), Pressure Ulcer Scale for Healing tool (PUSH), and other skin assessments, subjective global assessment, Patient-Generated-Subjective Global Assessment, and micronutrient biomarkers in plasma and wound exudate.

Three observational studies[25,26,28] found relationships between inadequate oral intakes, including Zn, with PIs, suggesting there is a connection between malnutrition and both PI development and healing. The fourth study[27] determined micronutrients are also lost from wound exudate. Of the clinical trials, three[29,30,32] concluded wound-specific ONS formulas in combination with standard PI care are superior to standard ONS formulas for wound healing outcomes. However, Bauer et al[32] did not find one formula to be preferable over the other.

No studies were found using Zn tissue measurements or the CZr ratio per exclusion criteria. Also, studies that use oral Zn sulfate as the intervention have not been conducted within the last 10 years. All intervention trials of ONS followed wound care protocols in all groups. Oral nutritional supplementation intervention studies[29–34] that met criteria contained several nutrients in addition to Zn that were also known to be beneficial for wound healing. These studies demonstrate dietary inadequacies are likely in older adults with PIs, and nutritional interventions are beneficial in improving wound healing.