About: Community nurse is an academic journal. The journal publishes majorly in the area(s): MEDLINE & Quality of life (healthcare). It has an ISSN identifier of 1351-1416. Over the lifetime, 267 publication(s) have been published receiving 782 citation(s).
Topics: MEDLINE, Quality of life (healthcare), Diabetes mellitus, Stoma (medicine), Nursing assessment
TL;DR: This paper reviews the possible relationship between certain nutrients and wound healing, evidence pointing to a connection between perioperative nutritional status and surgical outcome (including wound healing), and information concerning route of administration and prevention of deficiencies of certain nutrients.
Abstract: A review of the literature reveals that unfavourable surgical outcome, including problems with wound infection and dehiscence, sepsis, and longer lengths of stay, correlates well with the determination of perioperative malnutrition as measured by a variety of indices. Increased malnutrition and more severe surgeries are individually predictive of poorer outcome. There is evidence that particular deficiencies of nutrients are likely to cause wound healing problems. Particularly important nutrients include amino acids (notably glycine, proline, and arginine) carbohydrates, fatty acids (especially linoleic and linolenic), vitamins (particularly C and A), minerals and the elements (particularly magnesium, copper, phosphorous and selenium). The postoperative feeding of seemingly large amounts of amino acids is correlated with positive nitrogen balance and shorter hospital stays. The enteral route is preferred unless there is disturbed absorption or other complications. Total parenteral nutrition (TPN) formulations should include all of the essential nutrients, especially trace elements which were formerly overlooked. Introduction With surgery, as with trauma and sepsis, there is an increase in the requirement for calories, amino acids, vitamins, minerals, water and oxygen. This paper reviews the possible relationship between certain nutrients and wound healing, evidence pointing to a connection between perioperative nutritional status and surgical outcome (including wound healing), and information concerning route of administration and prevention of deficiencies of certain nutrients. 1. Princeton Associates for Total Health, 100 102 Tamarack Circle, Skillman, NJ 08558. 2. Columbia University School of Medicine. Nutrients Which May Affect Wound Healing \"Wound healing is a biochemical process and that nutrition itself is really a clinical biochemistry, and an obvious relationship between these two areas exists... Nutrition has to be thought of by all clinicians as the specific nutrient substrates that are being delivered to the specific cells and tissues at a given time. This is where nutrition really occurs, at the cell mem brane and in the cell, and it is only when we realize this and practice surgery with this in the proper context that we will then achieve optimal wound healing to correlate with the technical and other aspects of wound healing in which we engage as surgeons.\" H. Polk Protein and Amino Acid Balance Surgery, trauma and sepsis introduce a protein catabolic state. Wound healing is in part dependent on the ability of the body to provide adequate amounts of amino acids. Animal studies conducted by Harvey and Gibson showed that simultaneous supplementation with glycine, proline and arginine produced an increase of as much as 60-70% in nitrogen retained. This effect may be reversed if glycine alone is used. Arginine, which can be converted to proline, is associated with more rapid wound healing and greater collagen synthesis in animal models and may even inhibit post-trauma weight loss. 6 Furthermore, arginine-deficient rats rapidly lost collagen. Glycine accounts for approximately one-third of all amino acids found in most collagen alpha chains. Glycine and arginine are shown to be necessary for the synthesis of creatinine and for optimal growth in experimental animals. Furthermore, arginine detoxifies ammonia and detoxifies benzoic acid. Glycine may play a part in the repair of muscle fibers. Arginine converts to orni-