The Role of Nutrition in the Management of Lower Extremity Wounds

Abstract

From 3000 BC, healers have understood the importance of nutrition in wound care and used nutritional supplements to aid healing. Many of the teachings from Hippocrates, the father of modern-day medicine, clearly state his firm belief that good health can be achieved through nutrition. In the early 1900s when advances in biochemistry were frequent, many of the essential constituents of nutrition were characterized, which formed the basis for many animal and human wound-healing experiments. This led to the discovery of vitamin C, zinc, and many other components essential for the orderly progression of healing. Modern-day research has concentrated on finding nutritional components that can enhance healing through supra-physiological doses, such as in the use of the amino acids arginine and carnitine. However, clinicians need to be aware that approximately 50% of patients admitted to the hospital are malnourished, requiring dietary supplementation; appropriate nutritional assessment and advice therefore should be an integral part of all wound management. This review provides an up-to-date commentary on the role of nutrition in wound care, with specific emphasis on lower limb wounds, from a historical perspective, and within it both the biomedical approach and current herbalist practices are considered.

Impaired wound healing: facts and hypotheses for multi-professional considerations in predictive, preventive and personalised medicine

“…Consequently, deficiencies or depletions in carbohydrates, protein, fatty acids, vitamins, or micronutrients may lead to impaired wound healing [75]. In particular, carbohydrates are needed to supply energy for the healing process and have been shown to be the key factor for activating several enzymatic complexes essential for the wound repair [76][77][78][79]. Certain amino acids, specifically leucine, glutamine, and arginine, possess anabolic activity required for the healing process.…”

Modelos experimentais de desnutrição e sua influência no trofismo cutâneo

“…Nevertheless, during the mal nu tri tion pro cess, col la gen depo si tion falls, com pro mi sing the func tion of col la gen in healing the skin. 15,26,27 The results shown in the two models of mal nutri tion were simi lar irres pec ti ve of the model used, sho wing the nega ti ve effect of mal nu tri tion on skin tro phism in these ani mals, an effect that was con fir - …”

“…Serum albu min levels were simi lar in the two groups during fol low-up, pro bably due to the lack of tryptophan in gela tin, lea ding to a sup pres sion of nia cin, with the trypto phan that is pre sent in the body then being used to synthe si ze more impor tant endo ge nous pro teins, such as serum pro teins, in order to main tain nor mal levels. 26 With res pect to the his to lo gi cal analy sis, a reduc tion in skin tro phism (der mal thick ness) occurred in the ani mals in the mal nou ris hed groups com pared to the well-nou ris hed groups in both models.…”

Dietary Considerations of Wound Healing in Ayurveda

“…Specifically, it is involved in the hydroxylation of proline to form hydroxyproline. Research by Patel [18] confirms that ascorbic acid acts as a specific inducer of the collagen pathway. A deficiency in vitamin C is associated with poor collagen formation and delayed wound healing [18].…”