Is Treating Patients With Stage 4 Pressure Ulcers With Vitamins A and C, Zinc, and Arginine Justified?

Management of patients with pressure wounds often may entail the administration of vitamins A and C, zinc, and arginine. Supplementing these nutrients as part of a standard wound care protocol may increase the risk for toxicity and unnecessarily increase the cost of health care. This study aimed to correlate the nutritional status represented by albumin and prealbumin levels with aforementioned nutrient levels. This understanding would determine whether albumin and prealbumin levels have good predictive value in identifying patients with vitamin deficiencies in this population. Twenty patients aged 18 to 90 years were included, patients had to be admitted in the acute hospital setting with stage 4 pressure ulcers on their sacrum, hips, or heels. Patients already on vitamin supplements were excluded from the study. An odds ratio (OR) was used to assess the association between vitamin deficiency and albumin/prealbumin status. Fisher exact test was performed to test the significance of the association. The OR of vitamin A deficiency vs albumin deficiency was 0.27, but the association was not significant (95% CI, 0.004-3.68; P = .34). The OR of zinc deficiency vs albumin deficiency was 25.67 (95% CI, 1.2-568.9), and the association was significant (P = .01). The odds of a patient with vitamin C deficiency also having albumin deficiency was 0.62 times greater than that for patients without vitamin C deficiency. Vitamin A deficiency was more likely to be associated with prealbumin deficiency. Zinc deficiency was more likely to be associated with albumin deficiency. While arginine deficiency was more likely to be associated with albumin deficiency, and less likely to be associated with prealbumin deficiency, the results were not statistically significant. This study showed that routine treatment with vitamins A and C, zinc, and arginine in patients with stage 4 pressure ulcers is not justified.