A significant number of people who have acute, slow healing, or chronic wounds are nutritionally impaired. Proper wound healing is enhanced by taking in adequate amounts of dietary protein, Vitamin A, Vitamin C, Vitamin D, and Zinc, as well as hydration. Many people who have wounds eat a diet that consists of heavy amounts of carbohydrates and fats and not enough proteins, fruits, and fresh vegetables.
Wound healing occurs in 4 distinct phases.
Hemostasis- This phase occurs immediately after the wound is created and refers to a series of biologic processes which result in decreased bleeding.
Inflammatory Phase- This phase starts as bleeding is being controlled. During this phase a variety of specialized white blood cells and other immune system mediators are transported to the site of injury. This phase usually lasts for 2 weeks and causes localized swelling, pain, tenderness, and redness.
Proliferative phase- This phase usually lasts for 3 to 4 weeks. In this phase large numbers of special cells called fibroblasts produce collagen. Collagen is a protein which is the primary “building block” of the structure of all live animals. Without collagen there would be no bones, muscle, skin or wound healing. This is the phase in which the wound becomes smaller by contraction and is covered with new skin. This is also the most common phase in which wounds “get stuck” and stop healing.
Remodeling- This is the final stage of wound healing and lasts for up to 1 year after the wound was formed. During this time collagen fibers become linked together and increase the strength of the final scar. The scar continues to shrink and changes color from red to the normal skin color.
Proper nutrition is necessary for the phases of wound healing to proceed normally. The single most important nutritional supplement needed is protein. Dietary protein is broken down into amino acids which are used by fibroblasts to synthesize the new structural proteins and are essential for wound healing and the repair of injured tissues. If dietary intake of protein is inadequate, healthy protein from other body tissues will be broken down and used for wound healing. This is obviously counterproductive for the otherwise healthy tissues such as muscle and bone. It is recommended to take protein supplements in addition to animal protein eaten daily with meals. There are numerous products available at most grocery stores and pharmacies. The recommended dose is 2 servings per day of a 30gm protein supplement. Patients with diabetes need a supplement that has reduced sugars, and patients with renal failure or liver problems may also require a specialized protein supplement to avoid metabolic complications. Please consult with your physician if you have renal failure or liver problems prior to purchasing an over the counter supplement.
Several specific vitamins and minerals are also crucial for the phases of wound healing to proceed normally.
Vitamins A, C, D, and Zinc are required in various stages of the wound healing process and in the regulation of a healthy immune system as well. Normal daily multivitamins do not contain adequate amounts of these to enhance wound healing. In addition to a daily over-the-counter vitamin the recommended doses of these are as follows:
Vitamin A- 5000 units per day
Vitamin C- 2000mg per day
Vitamin D3- 5000 units per day
Zinc- 50mg per day
In summary, proper nutrition is one of key factors in proper wound healing. The best results in successful healing of difficult wounds are seen in a qualified Wound Care Center where the providers are trained in taking care of the whole patient to ensure wound healing. They review important factors involved in wound healing and monitor each patient closely until a successful outcome is achieved.