The method of repair that follows once an injury has occurred to the skin or soft tissues is termed wound healing. Wounds could result from trauma or from a surgical incision. We might also consider pressure ulcers (additionally known as decubitus ulcers) as wounds. The capacity of a wound to heal depends partly on its depth, and on the general health and nutritional standing of the patient.
Following an injury, an inflammatory response happens and the cells beneath the dermis (the deepest skin layer) start to provide collagen. Later, the epithelial tissue (the outer skin layer) is regenerated. By initially influencing these reparative processes, and secondly, limiting the damaging effects of inflammation, dietary modification and nutritional supplements might improve the quality of wound healing.
Dietary changes: Because the underlying tissues of the skin are created of protein, the patient requires an adequate quantity of calories and protein to create and repair this tissues when wounded. Whereas major wounds from extensive injuries or surgery significantly raise the protein and calorie requirement, the optimal healing of minor wounds should not need changes from a normal healthy diet. (1)
A review recently proved that malnourished folks with skin ulcers showed a major decrease in the size of their ulcers when given a diet that contained 24% protein. Conversely patients showed no improvement when given just 14% protein. This study suggests that an increase in dietary protein will enhance wound healing in malnourished individuals. We can then assume that the same benefits would be observed in people that are well-nourished.
Casein is a milk protein and has the ability to form a gel or clot in the stomach. This ability makes it very efficient in nutrient supply. The clot is able to supply a sustained slow release of amino acids into the blood stream, generally lasting for many hours (3). Casein is a sensible source of essential amino acids, predominantly glutamic acid. It also contains proline, aspartate, leucine and lysine, which are necessary for wound healing.
People of every age group could very well benefit from whey protein usage. It provides a variety of benefits in areas including sports nutrition, weight management, immune support, bone health and general wellness. BCCAs (branched chain amino acids) are crucial in healing and regeneration processes and come in the highest amounts when provided from whey protein. Other benefits of whey include the fact that it is simply absorbed that helps to increase lean muscle mass (4). This is often indispensable for quicker wound healing.
Studies are can verfy that 10-30 grams of ornithine alpha-ketoglutarate (OKG) given to people with severe burns and other forms of injuries per day produces faster wound healing and reduces the time spent in a hospital. Additionally major trauma and surgery patients have been shown to have enhanced healing times just from taking oral supplements that consist of several grams of glutamine per day(6).
Arginine supplementation increases protein synthesis and improves wound healing in animals. Two controlled trials have shown an increased tissue synthesis in surgical wounds in folks given 17 to twenty five grams of oral arginine every day (7) (8).
The connective tissue found in skin, tendons, ligaments, and joints is manufactured by the body when it recieves glucosamine sulfate and chondroitin sulfate (which both provide the raw material essential to do this. Results of analysis on the value of oral supplements of glucosamine or chondroitin for wound healing are also unavailable. Caroline is a tiny molecule composed of the amino acids histamine and almandine. The precise biological role of Caroline is not completely understood, however animal research demonstrates that it promotes wound healing. A lot of research is necessary in this subject.
In animal studies Thiamine (Vitamin B1), Pantothenic acid (Vitamin B5) and other B vitamins (9) have been significant in wound healing. For that reason high potency B vitamin supplements are suggested by medical practitioners to promote wound healing.
Vitamin C is needed to create collagen (connective tissue). It helps to strengthen skin, muscles and blood vessels, and it additionally ensures proper wound healing. Since deficiencies in Vitamin C holdup wound healing it is useful to amplify Vitamin C after an injury. A combination of 1 to three grams each day of vitamin C and two hundred to 900 mg every day of pantothenic acid has produced minor improvements in the strength of healing skin tissue (10).
Vitamin A plays a central role in wound healing, nevertheless the impact of supplemental vitamin A in individuals who have suffered a minor injury and aren't Vitamin A-deficient remains unclear. In individuals taking corticosteroid medication for skin injuries vitamin A supplements have been shown to expedite the skins healing process (11). Though there are no studies based mostly on humans, some physicians suggest 25,000 IU of vitamin A each day, beginning 2 weeks previous to surgery and continuing for four weeks after surgery.
Animal studies have shown that vitamin E supplements will decrease the formation of unwanted adhesions following a surgical wound. Animals fed a Vitamin E-rich diet were also shown to heal faster than animals who failed to receive the extra supplement.
Many enzymes, including some that are required to repair wounds, are composed of Zinc. Even the recovery from every day tissue damage, along with significant trauma, may be negatively affected by a light zink deficiency. One controlled trial found that the healing time of a surgical wound was reduced by forty three percent with oral supplementation of 50 mg of zinc (in the form of zinc sulfate) three times per day.
Copper is a needed co-factor for the enzyme lysyl oxidase, that plays a job within the cross-linking, and strengthening, of connective tissue. Other trace minerals, such as manganese, copper and silicon, are known to be necessary in the biochemistry of tissue healing. However, there are no controlled trials to explore the result of oral supplementation of these minerals on the rate of healing.
Though various factors are known to be vital in wound healing, the only supplements that has had a documented useful impact on it are certain amino acids, proteins like whey and casein, and water soluble vitamins (Vitamin B complex and Vitamin C).
References
1. Souber WW: Diet and Nutrition in the Care of the Patient with Surgery, Trauma and Sepsis. In Shils ME, Olson JA, Shike M ET AL. Modern Nutrition in Health and Disease, 9th Ed. Baltimore: Williams & Wilkins, 1999, 1589-618.
2. Breslow RA, Hallfrisch J, Guy DG et al. The Importance of Dietary Protein in Healing Pressure Ulcers. J Am Geriatr Soc 1993; 41C4: 357-62
3. Bairie Y., et al: Slow and fast dietary proteins differently modulate post-prandial protein accretion. Proclamations of National Academy of Sciences 94. 14930-14935.
4. www.qfac.com/whey-protein-2.html
5. Cynober L. Ornithine Alpha-ketoglutrate in Nutritional Support. Nutrition 1991; 7:313-22 (Review)
6. Romitio RA. Early administration of enteral nutrients in critically ill patient AACN Clin Issues 1995; 6: 242-56
7. Kirk SJ et.al. Arginine stimulates wound healing and immune function in elderly human beings. Surgery 1993; 114:155-60
8. Barbul A et.al. Arginine enhances wound healing and lymphocyte immune responses in humans Surgery 1990; 108:331-7
9. Bosse MD.et.al. Wound healing in rats with biotin, pyridoxine or riboflavin deficiency. Proc Soc Exp Biol Med 1948; 67: 418-21
10. Vaxman F. Effect of Pantothenic acid and Ascorbic Acid supplementation on human skin, wound healing powers. A double blind prospective and randomized trial. Eur Surg Res 1995; 27: 158-66
11. Hunt TK et.al. Effect of Vitamin A on reversing the inhibitory effect of cortisone on healing of open wounds in animals and man.
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