Wound repair in adults is most sensitive to deficiencies of several micronutrients that support collagen production, immune defense, oxygen delivery, and cellular proliferation. Evidence from the Office of Dietary Supplements National Institutes of Health identifies vitamin C, zinc, iron, and vitamin A as especially important for wound healing, with vitamin D, copper, and the B vitamins also contributing to recovery and resistance to infection. The World Health Organization highlights the global burden of micronutrient deficiencies and their downstream effects on morbidity, including impaired tissue repair.
Biological roles and common causes of deficiency
Vitamin C is essential for collagen hydroxylation and matrix formation; insufficient intake or scurvy markedly delays closure and weakens new tissue. Zinc is a cofactor for metalloproteinases and DNA synthesis that support re-epithelialization and immune cell function. Iron supports oxygen transport and cellular respiration in healing tissues; iron deficiency anemia reduces oxygen delivery and can slow repair. Vitamin A modulates epithelial differentiation and innate immunity. Vitamin D influences innate immune responses and may affect inflammation resolution, while copper is required for collagen cross-linking. Deficiencies arise from inadequate dietary intake, malabsorption (for example after bariatric surgery), chronic inflammation, advanced age, restrictive diets, and socioeconomic or regional food insecurity, as documented by public health reports from the World Health Organization.
Consequences, assessment, and contextual nuances
Clinically, these deficiencies lead to delayed wound closure, increased risk of infection, poor scar strength, and progression to chronic nonhealing wounds. Populations at particular risk include older adults, people with chronic diseases such as diabetes or chronic kidney disease, individuals with restricted or culturally specific diets low in animal-source foods, and communities facing food insecurity or environmental disruption. The Office of Dietary Supplements National Institutes of Health recommends assessing nutritional status when wounds fail to progress and treating documented deficiencies rather than broad unsupervised supplementation. Local cultural dietary practices and territorial food availability shape both the risk and the practical interventions: culturally acceptable food-based strategies are often the most sustainable approach to prevention.
Integrating targeted nutritional assessment into wound management improves outcomes and reduces complications; clinicians should combine dietary history, focused laboratory testing, and evidence-based replacement guided by authoritative sources such as the World Health Organization and the Office of Dietary Supplements National Institutes of Health.