Total Enteral Nutrition Facilitates Wound Healing Through Preventing Intestinal Atrophy, Keeping Protein Anabolism and Suppressing Inflammation

Abstract

BackgroundIn clinical settings, early total enteral nutrition (TEN) is known to reduce the postoperative complication and infection rate as well as duration of postoperative stay compared with total parenteral nutrition (TPN) in a variety of critical conditions. We aimed to compare effects TEN and TPN on wound healing and explore its possible mechanisms using rat model.MethodsSeven days after operation for inserting enteral tube into gastric space for TEN, Sprague-Dawley rats were made burn (15 mm) in the back. Rats were administrated with either TEN (N = 17) or TPN (N = 15) and evaluated condition of wound healing as well as serum/urine immunological and biochemical parameters at 28 days.ResultsBurned area was significantly reduced in TEN than in TPN group. Although body weight, serum levels of total protein, albumin and transferrin were the same levels between the two groups, urine nitrogen and intestinal atrophy were significant in TPN group. Conversely, weight of small bowel showed positive linear relationship with levels of parameters calculated as follows: [medication nitrogen quantity – (urine nitrogen + feces nitrogen)]/[medication nitrogen – feces nitrogen quantity]. Weights of spleen and tumor necrotizing factor-a levels in serum were higher in TPN than in TEN.ConclusionsThese results suggest that TEN may facilitate wound healing compared with TPN through preventing intestinal atrophy, keeping protein anabolism and suppressing inflammation.

Esophageal Endoscopic Vacuum Therapy with Enteral Feeding Using a Sengstaken-Blakemore Tube

“…In clinical settings, early enteral nutrition is known to reduce postoperative complications and to improve wound healing compared with TPN. An animal study showed that total enteral nutrition may facilitate wound healing compared with parenteral nutrition by preventing intestinal atrophy, suppressing inflammation, and maintaining protein anabolism [ 7 ]. Additionally, early enteral feeding has been shown to reduce anastomotic leakage, wound infection, pneumonia, and mortality compared with TPN after gastrointestinal surgery [ 8 ].…”

Nutrition and Antibiotics for Acute Pancreatitis

“…Animal studies showed that sustained enteral nutrition helps to maintain villus height and immunity leading to reduced bacterial translocation and decreased risk of the complications of pancreas necrosis and infection. 8,9 Paneth cell, which protects host from both commensal and pathogenic bacteria, was compromised in a mouse starvation model. 10 Increased bacterial translocation to mesenteric lymph nodes was also observed in the study.…”