Quain Angela M, Khardori Nancy M
Eastern Virginia Medical School, Norfolk, VA.
Wounds. 2015 Dec;27(12):327-35.
Wound care is a multidisciplinary specialty requiring many physiologic and immunologic processes as well as physical, social, and societal factors to achieve successful wound closure. Most wounds are treated with combinations of antimicrobials, protective barriers, and topical growth agents, including skin and biologic grafts.The role of nutrition in wound healing may be overlooked in the wound care patient. Like the specialty, it is often multifaceted, with many nutritional components playing a variety of roles in the wound healing process. Suboptimal nutrition can alter immune function, collagen synthesis, and wound tensile strength, all of which are essential in the wound healing process. It is also important to remember that not all wounds are equal: a burn is different from a diabetic foot ulcer, which is different from a pressure ulcer. Nonetheless, nutrition is a common denominator for all wound patients, and what is studied in 1 wound population is often relevant in another. Due to the complexities of monitoring and measuring both wound healing and dietary intake, randomized, controlled trials of wound care patients are difficult to conduct, and much of the data concerning nutrition in wound care relies on combined supplements. In summary, it appears that some nutrients are necessary only if deficient, whereas others may become conditionally essential and serve a therapeutic role. All of the nutrients discussed should be viewed as a component of a broader, complete diet. This article is a summary of wound healing and the roles of a variety of macronutrients and micronutrients in the process.
伤口护理是一个多学科专业,需要许多生理和免疫过程以及身体、社会和社会因素来实现伤口的成功愈合。大多数伤口采用抗菌药物、防护屏障和局部生长因子(包括皮肤和生物移植物)联合治疗。伤口护理患者的营养在伤口愈合中的作用可能被忽视。与该专业一样,营养通常是多方面的,许多营养成分在伤口愈合过程中发挥着多种作用。营养状况欠佳会改变免疫功能、胶原蛋白合成和伤口抗张强度,所有这些在伤口愈合过程中都至关重要。同样重要的是要记住,并非所有伤口都是相同的:烧伤不同于糖尿病足溃疡,糖尿病足溃疡又不同于压疮。尽管如此,营养是所有伤口患者的一个共同因素,在一类伤口人群中所研究的内容往往与另一类相关。由于监测和测量伤口愈合及饮食摄入的复杂性,很难对伤口护理患者进行随机对照试验,而且许多关于伤口护理中营养的数据依赖于联合补充剂。总之,似乎有些营养素仅在缺乏时才是必需的,而其他营养素可能会成为条件必需营养素并发挥治疗作用。本文总结了伤口愈合以及各种宏量营养素和微量营养素在这一过程中的作用。