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Journal Article

Nutrition and wound healing.

01 Aug 1998-Community nurse (Community Nurse)-Vol. 4, Iss: 7, pp 29-32
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-
Citations
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Journal ArticleDOI
TL;DR: Vit-B-complex supplement in combination with AFS resulted in statistically significant superior CAL gains when compared to placebo and Stratified data demonstrated significantly better results for the test group in both shallow and deep sites.
Abstract: Background: Reports have demonstrated that nutrient supplements, in particular vitamin-B complex (Vit-B), can positively influence wound healing processes. However, limited information is available on the effects of Vit-B on periodontal wound healing. Methods: A total of 30 patients (13 males, 17 females) presenting with generalized moderate to severe chronic periodontitis were enrolled in this study. All subjects presented ≥ two teeth in the same sextant with probing depth (PD) ≥5 mm and bleeding upon probing (BOP) in need of access flap surgery (AFS). This study was a randomized, double-masked, placebo-controlled clinical trial. Subjects were instructed to take one capsule a day of either Vit-B (50 mg of the following: thiamine HCl, riboflavin, niacinamide, d-calcium pantothenate, and pyridoxine HCl; 50 µg each of d-biotin and cyanocobalamin; and 400 mcg of folate) or placebo for 30 days following AFS. Clinical attachment levels (CAL) and N-benzoyl-dl-arginine-2- naphthylamide (BANA) test scores were me...

71 citations

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TL;DR: The goals of therapy include the management of pain and functional impairment by suppressing inflammatory responses, as well as reducing the frequency of recurrences or avoiding the onset of new aphthae.
Abstract: The treatment of recurrent aphthous stomatitis (RAS) still remains nonspecific and is based primarily on empirical data. The goals of therapy include the management of pain and functional impairment by suppressing inflammatory responses, as well as reducing the frequency of recurrences or avoiding the onset of new aphthae. For common forms of RAS, standard topical treatment options that provide symptomatic relief include analgesics, anesthetics, antiseptics, anti-inflammatory agents, steroids, sucralfate, tetracycline suspension, and silver nitrate. Dietary modifications may also support therapeutic measures. In resistant cases of benign aphthosis or aphthosis with systemic involvement, appropriate systemic treatment can be selected from a wide spectrum of immunomodulators that include colchicine, prednisolone, cyclosporine A, interferon-a, tumor necrosis factor-a antagonists, antimetabolites, and alkylating agents.

60 citations

Journal ArticleDOI
TL;DR: Nurses based in hospital and the community have a key role to play in identifying and monitoring patients who may be nutritionally at risk and require nutritional support to aid the wound healing process.
Abstract: Nutrition is a crucial aspect of a holistic approach to the healing of wounds, including pressure ulcers and leg ulcers. Poor nutritional status and support can delay the wound healing process or cause inadequate healing when nutritional deficiencies are not corrected. Nutritional screening is an important part of the overall clinical assessment of patients. Nurses based in hospital and the community have a key role to play in identifying and monitoring patients who may be nutritionally at risk and require nutritional support to aid the wound healing process. Patients' nutritional requirements may need to be met through the use of nutritionally complete supplements or, if oral intake is poor, with enteral or parenteral nutrition.

38 citations

Journal ArticleDOI
TL;DR: No relation was found between susceptibility to infections and menstrual status and Women athletes with menstrual dysfunction were found to have had a longer interruption of training due to musculoskeletal injuries than those with regular cycles.
Abstract: Strenuous exercise by women is associated with menstrual dysfunction, eating disorders and osteoporosis. Intensive training may also increase the susceptibility to infections. In this study, we invest

36 citations

01 Jan 2001
TL;DR: Given the important role played by nutrients in wound healing, all patients with wounds should receive a nutritional assessment and action must be taken to address any deficiency.
Abstract: he role of nutrition in the healing of wounds and the promotion of health is a low priority for many in health care, even though their importance is widely accepted. It is essential this trend is reversed, and that practitioners become more knowledgeable about the role of nutrition in wound healing. This article aims to encourage this by first identifying the role of nutrients and minerals in the wound healing process and then suggesting methods of nutritional assessment. The role of nutrients Carbohydrates As the body attempts to heal, so its metabolic rate increases and subsequently the demand for carbohydrates. Cellular activity, such as the metabolism of leucocytes and fibroblasts, is fuelled by adenosine triphosphate, which is derived from glucose. Carbohydrates are broken down to provide the glucose.

33 citations

References
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Journal ArticleDOI
TL;DR: A multiparameter index of nutritional status was defined relating the risk of postoperative complications to baseline nutritional status, providing an accurate, quantitative estimate of operative risk, permitting rational selection of patients to receive preoperative nutritional support.
Abstract: Based on assessment of 161 nonemergency general surgical patients, a multiparameter index of nutritional status was defined relating the risk of postoperative complications to baseline nutritional status. When applied prospectively to 100 gastrointestinal surgical patients, this index provided an accurate, quantitative estimate of operative risk, permitting rational selection of patients to receive preoperative nutritional support.

1,127 citations

Journal ArticleDOI
TL;DR: Results suggest that relatively isolated chromium deficiency in man, hitherto poorly documented, causes 1) glucose intolerance, 2) inability to utilize glucose for energy, 3) neuropathy with normal insulin levels, 4) high free fatty acid levels and low respiratory quotient and, 5) abnormalities of nitrogen metabolism.

590 citations

Journal ArticleDOI
TL;DR: The clinical results can be explained by the improvement in various indices of humoral and cellular immunocompetence and the protein status in the PPN group and their deterioration in the control group during the preoperative course.

421 citations

Journal ArticleDOI
TL;DR: Evidence is added for the essentiality of Se in man and the need to consider Se supplementation in long- term TPN and the close association between erythrocyte Se and GSHPx activity withTPN and blood transfusion could indicate that for these patients ery throat Se was largely determined by Se from GSHpx.

410 citations