Nutritional implications in wound healing.

Healing of wounds is one of the life functions which is intended as a defense mechanism to maintain the integrity of the body. Understanding basic factors that guide the healing process will help the clinician to propitiate those nutritional measures known to enhance the repair function. Nutrients are normally required for growth, development, and maintenance of the integrity of the tissue. The sum total of the nutritional requirements of all tissues and organs constitutes the requirements of the individual. Recommended dietary allowances have been defined for population groups in the United States for different ages and sex. These allowances involve some 17 different nutrients, but many others (up to 50) are now considered essential, although their exact requirement may not be known. When trauma of any sort is inflicted on an individual, both local and general metabolic changes take place which may lead to nutritional inadequacy. These reactions are normally intended to set into motion the mechanisms designed to repair injured tissues. Nutritional management of the individual requires that the clinican determines what, how, when, and how much nutritional supplementation should be given to the patient. Guidelines for the amounts of proteins, vitamins, and certain minerals to be administered have been discussed. Where there are impediments that make it impossible to feed the patient orally, the clinician should resort to parenteral feeding to insure that nutrients are provided for the convalescing patient. Because the trophic environment will determine to a large extent the speed with which tissues will recover, nutritional care of the patient is important and should be interrelated to the total care of the patient.