The management of pressure ulcers (PUs) has become increasingly important in the setting of an aging population. Nutritional approach is essential for patients with PUs, although there is currently limited evidence supporting nutritional interventions for PU treatment. Zinc is widely accepted to play a crucial role in wound healing, whereas there is as yet no evidence for the efficacy of oral zinc therapy (in the form of zinc alone) in PU healing. Most recently, we reported the therapeutic effects of polaprezinc (zinc L-carnosine complex) on PU, along with those of L-carnosine alone. L-carnosine is an endogenous dipeptide (comprised of β-alanine and L-histidine) and possesses many biological functions. Therefore, L-carnosine has recently been hypothesized to have potential therapeutic benefits for a considerable spectrum of age-related diseases. Its zinc complex polaprezinc has been a commonly prescribed medication for gastric ulcers in Japan since 1994. In the treatment of PUs, the potency of L-carnosine was far greater than we expected. Polaprezinc was more potent than L-carnosine, but did not differ significantly. Accordingly, whether oral zinc exerts a therapeutic benefit remained unclear from our finding as well as other past studies. This review article summarizes the results of our two clinical trials; part 1 was a 4-week nonrandomized controlled trial designed to examine the efficacies of polaprezinc and L-carnosine and to compare the potency of two agents; and part 2 was a case series for evaluating the efficacy and safety of maximum 8-week polaprezinc treatment. Polaprezinc is a tablet and therefore easy-to-use, as compared to high-protein/energy beverages that have often been used for PU treatment. It can be a novel therapeutic option for PUs as their oral treatment. We finally provide a perspective of future research.

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