I do not believe there are agreed-upon standards for dosing of micronutrients; it is agreed the nutrients you mentioned are utilized in increased amounts in the healing wound, and a deficiency of protein, vitamin C/A or zinc can delay the wound healing process. Will attach references I have used:

Schols J, Heyman H; Journal of Tissue Viability (2009); 18, 72e79

Desneves K, Todorovic B; Clinical Nutrition (2005) 24, 979 - 987

Mirastschijski U, Martin A; Biol Trace Elem Res (2013) 153:76–83

Little M; Curr Opin Clin Nutr Metab Care 2013, 16:39–49

hi,

here is a french guideline about pressure ulcere and nutrition

http://www.epuap.org/guidelines/QRG_Prevention_in_French.pdf

And a nice guideline. https://www.nice.org.uk/guidance/CG179/chapter/introduction

Indeed nutrition is essentiel in pression ulcers healing. 

The daily protein ration is 1g/kg/day, when wound it is: 2.5g/kg/day

best regards

Dear Rachel,

I would suggest you to monitor as principal nutritional index the prealbumin level (as you know is the most reliable nutritional index ) : remember that if the patient is a spinal cord injured one, you have a tissue / coutaneous trophic problem linked to the neuronal section which hampers any healing whatever you do;

a practical issue could be administering some steroids (testosterone) to spur a faster recovery

Dear Rachel

there is as far as I know, once again, no clear evidence about the amount and duration of treatment with any of the available nutritional supports in Pressure Sores. There is increasing evidence about their effect on the global healing, but we still don't know how much and how long. Most products are meant to be taken from the first day until the complete closure of the wound. Is it really usefull to give them for a wide open, not yet debrided, strongly exsudating (proteins!) wound? I'm not sure...

Though we know that nutrition is important in pressure ulcer healing, we still don't know what to give, when to start and when to stop (i.e. in which phase of the wound healing process), nor how much of it.

You may find interesting informations about it in the works of W.O. Seiler about pressure sores and nutrition, and the use of a "nutrogramm". We have to be careful about the interpretation of the results of those index measures, many of these markers being acute phase proteins. Inflammation processes in and around the pressure sore itself may explain pathological level of such markers as praealbumin (transthyretin) and therefore mask the true nutritional state. We may need also to make a difference between pressure sores in different populations: do geriatric patients show the same values/needs/risks than spinal cord injured (thanks to Alessandro for his statement) or ICU patients? I don't think so.

And last but not least, as ever: first relieve the pressure, and only after it's done start correcting the risk factors.

I hope you find answers and share them with us. We still need much more evidence about the optimal use of nutriments in pressure sores treatment.

best regards

Xavier

Thank you all for your help! 

Hi;

Dear Rachel, many factors affected in wound healing process, especially when used oral administration method. Anyway, generally, any compound or substance with antioxidant properties, such as vitamin C, is effective in accelerating the healing process. 

Perhaps the articles mentioned below, is useful for you :

1- The importance of patients' nutritional status in wound healing. Br J Nurs. 2001 Mar;10(6 Suppl):S42, S44-9.

2- Food and wounds: nutritional factors in wound formation and healing. Br J Community Nurs. 2002 Sep:43-4, 46, 48 passim.

3- Nutrition and wound healing: the necessity of assessment. Br J Nurs. 2005 Oct 27-Nov 9;14(19):S30, S32, S34 passim.

4- Understanding the Role of Nutrition and Wound Healing.

Nutr Clin Pract February 2010 25: 61-68,

Scholarly articles for nutrition and wound healing

5- Nutrition and wound healing - ‎Arnold - Cited by 164

6- Nutrition and wound healing - ‎Albina - Cited by 118

7- Nutrition and wound healing - ‎Williams - Cited by 106

8- The role of vitamin C in wound healing - ‎Hunt - Cited by 133

9- Arginine Stimulates Wound Healing and Immune … - ‎Sax - Cited by 322

10- Role of arginine in trauma, sepsis, and immunity - ‎Kirk - Cited by 188

11- … arginine metabolism: a proposed role in wound healing - ‎Shearer - Cited by 178

Good luck

Hi Rachel.  I'm a registered dietitian nutritionist and I frequently work with patients that have wounds, especially pressure ulcers..  This is what we use as the gold standard (in the U.S.) for nutrition care of pressure ulcers:

The Role of Nutrition in Pressure Ulcer Prevention and Treatment: National Pressure Ulcer Advisory Panel White Paper, by the National Pressure Ulcer Advisory Panel.

I'm not sure if you can retrieve a free copy so I've attached a file for your convenience.

Also, someone mentioned prealbumin; however, I do not recommend wasting money on testing prealbumin as it is an indicator of inflammation which will be present when there is a wound, so it will be low.  The research does not support the use of prealbumin (or albumin) as an indicator of nutrition status.

Hope that helps.

Laure