The example of treatment shows the healing process in an 83-year-old female patient with a large sacral third degree decubitus ulcer. To eliminate catabolism as a disruptive element of wound healing, an adequate nutritional therapy was carried out consistently.

Fig. 1 of July 17, 1999: Sacral decubitus ulcer with minor or lacking healing tendency, no granulation tissue, ulcer margins undermined, no reaction in the ulcer margin. Nutrition parameters: Albumin 17 g/l, zinc 8.0 mmol/l, lymphocytes 529.

Fig. 2 of July 24, 1999: Healing tendency somewhat better, little red granulation tissue, no epithelization from the ulcer base, undermined ulcer margins. Nutrition parameters: Albumin 20 g/l, lymphocytes 908/mm3.

August 25, 1999: The ulcer has become smaller, the healing tendency is better, more than 80 % of the wound shows clean, red granulation tissue, ulcer margins are no longer undermined, epithelization over the flat ulcer margins. Nutrition parameters: Albumin 28 g/l, lymphocytes 1309/mm3.

The change from catabolic to anabolic metabolism has occurred, which is indicated by the normal CRP. The planned operation on the ulcer (dermoplasty) can be performed now.