The Impact of Malnutrition on the Wound Healing Process: A Summary of Current Knowledge
DOI:
https://doi.org/10.12775/QS.2026.50.68066Keywords
malnutrition, wound healing, chronic wounds, surgical-site infection, micronutrients, clinical nutritionAbstract
Aim:
The aim of this narrative review was to summarize current PubMed-indexed evidence on the impact of malnutrition on the wound healing process and to synthesize clinical data regarding nutritional interventions that may improve wound outcomes.
Materials and Methods:A narrative literature review was conducted based exclusively on peer-reviewed studies indexed in PubMed. Experimental studies, observational studies, randomized controlled trials, and systematic reviews addressing nutrition, malnutrition, and wound healing were included. Evidence from the provided publications and their referenced bibliographies was analyzed and synthesized qualitatively.
Results:Clinical and experimental evidence shows that malnutrition causes disruptions of all phases of wound healing by disturbing inflammatory control, decreasing collagen deposition, delaying angiogenesis and reducing fibroblast activity. Observational studies report a high prevalence of malnutrition among patients with chronic wounds, particularly pressure injuries and venous leg ulcers, and associate poor nutritional status with slower wound closure and higher complication rates. Randomized clinical trials and systematic reviews indicate that targeted oral nutritional supplementation, especially high-protein formulas enriched with zinc, arginine and antioxidants, improve healing effects in patients with pressure ulcers when they are used as an adjunct to standard wound care.
References
[1] Demling RH.
Nutrition, anabolism, and the wound healing process: an overview.
Eplasty. 2009;9:e9.
PubMed: https://pubmed.ncbi.nlm.nih.gov/19274069/
[2] Stechmiller JK.
Understanding the role of nutrition and wound healing.
Nutr Clin Pract. 2010;25(1):61–68.
doi: https://doi.org/10.1177/0884533609358997
PubMed: https://pubmed.ncbi.nlm.nih.gov/20130158/
[3] Molnar JA, Underdown MJ, Clark WA.
Nutrition and chronic wounds.
Adv Wound Care (New Rochelle). 2014;3(11):663–681.
doi: https://doi.org/10.1089/wound.2014.0530 PubMed: https://pubmed.ncbi.nlm.nih.gov/25371850/
[4] Quain AM, Khardori NM.
Nutrition in wound care management: a comprehensive overview.
Wounds. 2015;27(12):327–335. PubMed: https://pubmed.ncbi.nlm.nih.gov/27447105/
Available from:
[5] Alves CC, Torrinhas RS, Waitzberg DL.
Short-term specialized enteral diet fails to attenuate wound healing impairment in malnourished rats.
Nutrition. 2010;26(9):873–879.
doi: https://doi.org/10.1016/j.nut.2010.05.003
PubMed: https://pubmed.ncbi.nlm.nih.gov/20609545/
[6] Skórka M, Więch P, Przybek-Mita J, et al.
Nutritional status of people with a coexisting chronic wound assessed using bioelectrical impedance analysis.
Nutrients. 2023;15(13):2869.
doi: https://doi.org/10.3390/nu15132869
PubMed: https://pubmed.ncbi.nlm.nih.gov/37447196/
[7] Cederholm T, Barazzoni R, Austin P, et al.
ESPEN guidelines on definitions and terminology of clinical nutrition.
Clin Nutr. 2017;36(1):49–64.
doi: https://doi.org/10.1016/j.clnu.2016.09.004
PubMed: https://pubmed.ncbi.nlm.nih.gov/27642056/
[8] Cereda E, Klersy C, Serioli M, et al.
A nutritional formula enriched with arginine, zinc, and antioxidants for the healing of pressure ulcers: a randomized trial.
Ann Intern Med. 2015;162(3):167–174.
doi: https://doi.org/10.7326/M14-0696
PubMed: https://pubmed.ncbi.nlm.nih.gov/25643304/
[9] Jensen GL, Mirtallo J, Compher C, et al.
Adult starvation and disease-related malnutrition: a proposal for etiology-based diagnosis.
JPEN J Parenter Enteral Nutr. 2010;34(2):156–159.
doi: https://doi.org/10.1177/0148607110361910
PubMed: https://pubmed.ncbi.nlm.nih.gov/20375423/
[10] Clark RK, et al.
Evaluating the impact of using a wound-specific oral nutritional supplement to support wound healing in a rehabilitation setting.
Int Wound J. 2023;20(1):145–154.
doi: https://doi.org/10.1111/iwj.13849
PubMed: https://pubmed.ncbi.nlm.nih.gov/35684975/
[11] Cereda E, et al.
Efficacy of disease-specific nutritional support for pressure ulcer healing: a systematic review and meta-analysis.
J Nutr Health Aging. 2017;21(6):655–661.
PubMed: https://pubmed.ncbi.nlm.nih.gov/28537329/
[12] Mościcka P, Cwajda-Białasik J, Jawień A, Szewczyk MT.
Complex treatment of venous leg ulcers including the use of oral nutritional supplementation.
Postepy Dermatol Alergol. 2022;39(2):336–346.
doi: https://doi.org/10.5114/ada.2021.104730
PubMed: https://pubmed.ncbi.nlm.nih.gov/35645669/
[13] Alsharif AT, et al.
The impact of nutritional condition and compression treatment on venous ulcer recovery: a systematic review.
Cureus. 2024;16(4):e57407.
doi: https://doi.org/10.7759/cureus.57407
PubMed: https://pubmed.ncbi.nlm.nih.gov/38694674/
[14] Saino Y, Wakabayashi H, Maeda K, Nishioka S, Hao T, Mimatsu K. Rehabilitation nutrition in pressure ulcer management with type 2 diabetes: a case report. Asia Pac J Clin Nutr. 2018;27(3):728–734.
doi: https://doi.org/10.6133/apjcn.062017.05
PubMed: https://pubmed.ncbi.nlm.nih.gov/29737823/
[15] Ghaly P, Iliopoulos J, Ahmad M. The role of nutrition in wound healing: an overview. Br J Nurs. 2021;30(5)(Tissue Viability Suppl):S38–S41.
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Copyright (c) 2026 Miłosz Jan Rogiński, Antoni Liebert, Karol Krupiniewicz, Marek Wojciechowicz, Marta Brzęcka, Stanisław Rogiński, Mariusz Suchcicki, Łukasz Chojnowski, Katarzyna Mazurek, Anna Dominiczak
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