Introduction
Nutrition has an important effect on the healing of wounds. First of all, it provides essential vitamins and minerals for anti-inflammatory and anti-bacterial protection of an injured area. Moreover, nutrition is the source of amino acids, proteins, and collagen, in particular, necessary for the formation of new tissues in the process of healing. Finally, fats, fatty acids, glucose, and fats stimulate the generation of cellular energy essential for a stressed organism’s wound healing to prevent the formation of chronic wounds and the general deterioration of health conditions.
Discussion
Wound healing may be regarded as a multifaceted and highly complex process. It heavily relies on the body’s internal coordination and regulation activities for the replacement of devitalized tissue with new tissues and fresh blood vessels. As a multidisciplinary specialty, wound care requires multiple immunologic and physiologic processes for successful wound closure affected by social, societal, and physical factors (Rosenthal, 2020). The majority of wounds are traditionally treated using a combination of protective barriers, antimicrobials, and skin grafts as major growth agents. However, the role of nutrition in the process of wound healing is frequently underestimated.
At the same time, the formation of new tissue is associated with increased consumption of particular nutrients and energy. When the body is wounded and releases stress hormones, it launches the catabolic phase characterized by the change of metabolism “in order to supply the injured area with the nutrients it needs to heal” (“Nutrition and wound healing,” n.d., para. 2). In turn, this process may be affected by malnutrition referred to “all forms of deficiency, excess, or imbalance in a person’s intake of energy and/or nutrients” (Barchitta et al., 2019, p. 3). Thus, when this intake is insufficient, or nutrients are inadequate, the catabolic phase may last longer and lead to a protein energy malnutrition (PEM) state (“Nutrition and wound healing,” n.d.; Rosenthal, 2020). The PEM state inevitably causes multiple negative consequences for human health. First of all, when the body sends extra nutrients to an injured site, other organs will suffer from their lack. Moreover, the absence of appropriate nutrition may destroy a successful process of healing and lead to the formation of chronic non-healing wounds.
Wound care, especially in relation to chronic wounds, places a substantial financial burden on healthcare systems all over the world. According to Barchitta et al. (2019), “In the United States, it has been estimated that 3% of individuals over 65 years will have a wound at any one time, with an estimated cost to the healthcare system of approximately US $25 billion each year” (p. 1). In low-income countries, the situation is more crucial due to a lack of efficient medications, accessible medical services, and sufficient nutrition. In the present day, the World Health Organization (WHO), together with the Association for the Advancement of Wound Care (AAWC) Global Volunteers, identifies the necessity of an interdisciplinary approach to wound care. In this case, the assessment of the impact of nutrition on wound healing is essential for the contribution of this global issue’s potential solutions.
The process of wound healing has several phases, and nutrients play an essential role in all of them. The first stage is inflammation, characterized by the formation of a fibrin clot by coagulation factors and platelets as a protective barrier for an injured area (Rosenthal, 2020 Almadani et al., 2021). During this process, macrophages, neutrophils, and enzymes are essential for the removal of bacteria for the prevention of the wound’s inflammation (Bishop et al., 2018; Almadani et al., 2021). At the same time, appropriate nutrition helps facilitate this process, promoting an antibacterial effect in wound healing. First of all, the fibrin clot’s successful formation that prevents a wound from infection requires vitamin K and calcium that may be obtained from meat, dairy products, avocado, and leafy green vegetables.
Subsequently, particular vitamins and minerals stimulate the immune system for its efficient response to bacteria. For instance, in reasonable doses, vitamins A, B, E, and C increase one’s immunity and control the inflammatory phase. The sources of these vitamins are: green leafy vegetables, citrus fruits, potatoes, and tomatoes (vitamin C); dark green vegetables, fish, red fruits, and eggs (vitamin A); milk, eggs, cheese, meat, fish and shellfish, and green vegetables (vitamin B); and seeds, nuts, and vegetable oil (vitamin E) (Bishop et al., 2018). Finally, zinc is a major mineral involved in the improvement of the immune system during wound healing.
The second and third stages of the process of healing are proliferation and remodeling. Proliferation is characterized by angiogenesis, fibroblast activity, and epithelialization for tissue repair and building the foundation for new granulation tissue – in other words, “the wound starts to rebuild itself” (Bishop et al., 2018, p. 46). With the presence of fibroblasts and macrophages, an extracellular matrix, new capillaries, and new tissue are formed for general wound contraction. The last stage is associated with collagen maturation for the restoration of the skin’s integrity, increased tensile strength, and the formation of scar tissue.
The phases of proliferation and remodeling require energy and the creation of new tissues for successful wound healing. Due to adequate nutrition, the body receives protein that may be regarded as “the “building blocks” or the tools used to create new tissue” (Rosenthal, 2020, para. 9). According to Rosenthal (2020), the intake of protein for a healthy adult constitutes 0.8-1.2 g per kilogram per day. However, for patients with wounds when their organisms are stressed, a minimum of 1.5 g of protein per kilogram is required. Proteins are formed by amino acids, and their appropriate sources are fish, lentils, eggs, peanut butter, and beans.
At the same time, one of the most essential for the formation of new tissue proteins is collagen. Due to its resistance to stretching and rigidity, collagen supports connective tissues’ extracellular space being the perfect matrix for bones, ligaments, tendons, and skin (Wu et al., 2021). Collagen may be synthesized in the body and may be received with nutrition. Traditionally, collagen is provided through specific supplements in the form of powder or pills, as there is a lack of research dedicated to the absorption of collagen from food (“The nutrition source,” n.d.). In other words, collagen is traditionally split into amino acids in the stomach and may be transported all over the body according to its needs, even if there are products that contain collagen, such as gelatin, bone broth, and meat with connective tissue (“The nutrition source,” n.d.). Nevertheless, there is a list of products that stimulate collagen proliferation and maturation in the process of wound healing, including meat, dairy products, poultry, legumes, leafy greens, soy, eggs, fish, nuts, seeds, berries, citrus fruits, whole grains, tomatoes, and peppers.
At the same time, proper nutrition may be regarded as a source of energy for wound healing. Glucose, fats, essential fatty acids, and lipids stimulate cellular energy contributing to the formation of new tissues as well (Almadani et al., 2021). As a source of white cells’ energy, glucose is provided by glutamine synthesized by the body, however, in the case of the increased demand for wound healing, glutamine may be received from a diet rich in eggs, dairy products, chicken, beef, wheat, fish, Brussel sprouts, spinach, celery, and parsley. However, the existence of glucose-related diseases, such as diabetes, requires additional attention to nutrition in order not to stimulate their development and the occurrence of comorbidities. Mono- and polyunsaturated fats, fatty acids, and lipids received from vegetable oils, nuts, seeds, and oily fish generate energy for wound healing as well.
Conclusion
To conclude, sufficient and appropriate nutrition is highly essential for a successful process of wound healing. It does not presuppose an intensive consumption of food but a balanced intake of nutrients for energy and tissue formation. In turn, nutrition specialized in wound healing may contribute to the efficiency of this process at all of its stages. Thus, vitamins and minerals, such as vitamins A, B, C. E, and zinc, contribute to the improvement of the immune system for its anti-inflammatory response. Moreover, while the process of healing requires materials for the formation of new tissues, amino acids, nutrients, and collagen essential for the restoration of skin may be received from nutrition that may stimulate their proliferation as well. In addition, wound healing requires an increased amount of energy that may be provided through the consumption of products rich in fats, fatty acids, glucose, and lipids.
References
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Wu, M., Cronin, K., & Crane, J. S. (2021). Biochemistry, collagen synthesis. StatPearls. Web.