Wound Care Concierge Part II: Nutrition

Essential Nutrients in Wound Healing

Paul M. Graham, D.O.

Nutrition is one of the most important aspects of proper wound healing. With adequate intake of carbohydrates, fat, protein, vitamins, and minerals, the immune system has all the tools necessary for proper healing to take place. If nutrient intake is below what is required, the healing process will be disrupted and a wound will develop. This increasing the chance that the wound will not heal until an adequate amount of nutrients are supplied.

Individuals with wounds must consume adequate calories to support collagen and nitrogen synthesis, thus promoting healing and sparring essential protein from being used as an energy source. Protein is vital for tissue perfusion, synthesis of wound healing enzymes, proper immune function, and collagen production. It is highly suggested to consume 1.25 – 1.5 grams/kg body weight of protein for adults with wounds or injuries. Below, you will find recommendations and information that will assist you in developing a nutrition plan that will help facilitate and expedite wound healing.

1. Provide adequate caloric energy
   • Calorie requirements: 30-35 grams per kilogram of bodyweight (1 kg = 2.2 lbs)
2. Importance of Carbohydrates  
   • Stimulates insulin release, an anabolic hormone required for glucose to be used in cell proliferation and growth
   • Stored and converted into fat cells, which may play a role in reducing pressure onto the skin surface
3. Importance of Fats  
   • Provides energy and spares the use of lean muscle protein for wound healing
   • Aids in the absorption of Vitamin A
4. Importance of Protein  
   • Stimulates collagen synthesis, blood vessel formation (angiogenesis), tissue remodeling, and wound contraction
   • Healthy adults typically require 0.8 grams per kilogram of bodyweight
   • Compromised adults with wounds require 1.5 grams per kilogram of bodyweight
   • Protein deficiency will impair all stages of wound healing and reduce immune function
   • Amino acids, arginine and glutamine, act as building blocks to collagen synthesis and should be supplemented during the wound healing process

5. Importance of Vitamins  
   • Vitamin A is required for epithelial and bone formation, cellular differentiation, and immune function
   • Vitamin C is necessary for collagen formation and cross-linking, increase tensile strength, proper immune function, and as a tissue antioxidant
   • Vitamin E is the major lipid antioxidant in the skin
6. Importance of Zinc   
   • Provides increased wound strength, collagen synthesis, epithelialization, and increase immune function
7. Importance of Amino Acids  
   • Arginine is an amino acid responsible for increasing microvascular perfusion, thus increasing collagen production
   • Glutamine is a very important fuel source for rapidly dividing cells as it increases protein synthesis, thus indirectly supplying the body with building blocks for wound repair
8. Importance of adequate hydration  
   • Dehydration impairs the delivery of oxygen to the wound and decreases the availability of nutrients for proper healing to take place
   • It is very important to consume at least 2 liters of water daily for adequate blood supply to nourish the wound

Follow these recommendations and you will be amazed at how quickly a wound will heal with minimal scarring or discoloration. Remember, our diet is an essential part of life! If you have any questions, please feel free to contact me.

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