Arnold Meghan, Barbul Adrian
Department of Surgery, Sinai Hospital of Baltimore, and the Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Plast Reconstr Surg. 2006 Jun;117(7 Suppl):42S-58S. doi: 10.1097/01.prs.0000225432.17501.6c.
The relationship between nutrition and wound healing--after injury or surgical intervention--has been recognized for centuries. There is no doubt that adequate carbohydrate, fat, and protein intake is required for healing to take place, but research in the laboratory has suggested that other specific nutritional interventions can have significant beneficial effects on wound healing. Successful translation into the clinical arena, however, has been rare. A review of normal metabolism as it relates to wound healing in normoglycemic and diabetic individuals is presented. This is followed by an assessment of the current literature and the data that support and refute the use of specialized nutritional support in postoperative and wounded patients. The experimental evidence for the use of arginine, glutamine, vitamins, and micronutrient supplementation is described. Most of the experimental evidence in the field supporting the use of specialized nutritional support has not been borne out by clinical investigation. A summary of the clinical implications of the data is presented, with the acknowledgment that each patient's plan of care must be individualized to optimize the relationship between nutrition and wound healing.
营养与伤口愈合（损伤或手术干预后）之间的关系已被认识数百年。毫无疑问，愈合需要充足的碳水化合物、脂肪和蛋白质摄入，但实验室研究表明，其他特定的营养干预措施对伤口愈合可能有显著的有益影响。然而，成功转化到临床领域的情况却很少见。本文对正常代谢与血糖正常和糖尿病个体伤口愈合的关系进行了综述。随后评估了当前文献以及支持和反驳在术后和受伤患者中使用特殊营养支持的数据。描述了使用精氨酸、谷氨酰胺、维生素和微量营养素补充剂的实验证据。该领域支持使用特殊营养支持的大多数实验证据尚未得到临床研究的证实。本文给出了数据的临床意义总结，并承认必须针对每个患者制定个性化的护理计划，以优化营养与伤口愈合之间的关系。
