Chow Oliver, Barbul Adrian
Department of Surgery, University of Medicine and Dentistry of New Jersey , Newark, New Jersey.
Department of Surgery, Washington Hospital Center , Washington, District of Columbia.
Adv Wound Care (New Rochelle). 2014 Jan 1;3(1):46-53. doi: 10.1089/wound.2012.0415.
The role of immunonutrition in wound healing has been an area of both interest and controversy for many years. Although deficiencies in certain nutrients have long been known to impair healing, supplementation of specific immune modulating nutrients has not consistently yielded improvements in wound healing. Still, the prospect of optimizing nutrition to assist the immune system in wound repair bears great significance in both medical and surgical fields, as the costs of wound care and repair cannot be ignored. Recent studies have rekindled efforts to elucidate the roles of specific immunonutrients, and we now have a better understanding of the conditionally essential role of various nutrients such as arginine, which becomes essential in certain clinical situations such as for the trauma patient or patients at high risk for malnutrition. Immunonutrition in its current formulation usually includes supplementation with arginine, glutamine, omega-3 fatty acids, vitamins, and trace minerals, and its use has often been associated with decreased infectious complications and sometimes with improvements in wound healing. A key to understanding the role of immunonutrition in wound healing is recognizing the distinct contributions and importance of the various elements utilized. Critical areas for future study include identifying the specific populations, timing, and ideal composition of immunomodulating diets in order to optimize the wound healing process.
多年来，免疫营养在伤口愈合中的作用一直是一个既受关注又存在争议的领域。虽然早就知道某些营养素缺乏会损害愈合，但补充特定的免疫调节营养素并未始终如一地改善伤口愈合情况。尽管如此，优化营养以协助免疫系统进行伤口修复，在医学和外科领域都具有重大意义，因为伤口护理和修复的成本不容忽视。最近的研究重新激发了人们阐明特定免疫营养素作用的努力，我们现在对各种营养素（如精氨酸）的条件必需作用有了更好的理解，精氨酸在某些临床情况下（如创伤患者或营养不良高风险患者）变得必不可少。目前配方的免疫营养通常包括补充精氨酸、谷氨酰胺、ω-3脂肪酸、维生素和微量矿物质，其使用通常与感染并发症减少相关，有时还与伤口愈合改善有关。理解免疫营养在伤口愈合中作用的关键在于认识到所使用的各种元素的独特贡献和重要性。未来研究的关键领域包括确定免疫调节饮食的特定人群、时机和理想成分，以优化伤口愈合过程。
