From Tulane University School of Medicine; and the Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center.
Plast Reconstr Surg. 2021 Jul 1;148(1):226-238. doi: 10.1097/PRS.0000000000008061.
The role of nutritional intervention in wound care has been a topic of controversy. Although the efficacy of macronutrient supplementation has been well described, there is a paucity of evidence and no official recommendation regarding the use of vitamins and minerals to optimize wound healing. This is the first review of vitamin and mineral wound intervention that systematically summarizes the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and distills the evidence by wound type.
In this comprehensive review, the authors outline the nutrients and delivery methods used in the identified studies, analyze reported treatment outcomes, summarize nutrient effectiveness, and propose evidence-based conclusions to improve wound healing outcomes and enhance the consistency of nutritional intervention in wound care.
Thirty-six studies with a combined total of 2339 patients investigated the use of oral, topical, or intravenous vitamin and/or mineral supplementation for treatment of the following wound types: burn wounds (n = 3), pressure ulcers (n = 7), diabetic ulcers (n = 4), venous ulcers (n = 7), digital ulcers (n = 1), skin incisions (n = 9), hypertrophic scars (n = 4), and sinonasal wounds (n = 1). Improved outcomes were reported in patients with burn wounds receiving vitamins A, B1, B6, B12, D, and E and zinc, calcium, copper, magnesium, selenium, and zinc; patients with pressure ulcers receiving vitamin C and zinc; patients with diabetic ulcers receiving vitamin A, B9, D, and E; patients with venous ulcers receiving zinc; and patients with hypertrophic scars receiving vitamin E.
Based on the high-level data provided in this review, the use of specific nutritional interventions may improve the outcome of certain wound types. Further investigation is warranted to draw definitive conclusions.
营养干预在伤口护理中的作用一直是一个有争议的话题。虽然宏量营养素补充的疗效已经得到很好的描述，但关于使用维生素和矿物质来优化伤口愈合的证据很少，也没有官方建议。这是第一篇系统综述维生素和矿物质伤口干预的综述，该综述使用系统评价和荟萃分析首选报告项目的指南对文献进行了综述，并按伤口类型对证据进行了总结。
在这项全面的综述中，作者概述了在已确定的研究中使用的营养素和输送方法，分析了报告的治疗结果，总结了营养素的有效性，并提出了循证结论，以改善伤口愈合结果并增强营养干预在伤口护理中的一致性。
36 项研究共纳入 2339 例患者，研究了口服、局部或静脉给予维生素和/或矿物质补充剂治疗以下伤口类型的效果：烧伤伤口（n = 3）、压疮（n = 7）、糖尿病性溃疡（n = 4）、静脉溃疡（n = 7）、数字溃疡（n = 1）、皮肤切口（n = 9）、增生性瘢痕（n = 4）和鼻旁窦伤口（n = 1）。接受维生素 A、B1、B6、B12、D 和 E 以及锌、钙、铜、镁、硒和锌的烧伤患者、接受维生素 C 和锌的压疮患者、接受维生素 A、B9、D 和 E 的糖尿病性溃疡患者、接受锌的静脉溃疡患者以及接受维生素 E 的增生性瘢痕患者报告了改善的结果。
基于本综述提供的高质量数据，特定营养干预的使用可能会改善某些伤口类型的结果。需要进一步研究以得出明确的结论。
