Q: Are there other supplements besides vitamin C and zinc that should be considered in wound healing?
A: A question was recently raised related to the use of vitamin C and zinc in the healing of pressure ulcers. Not only are they important, but the addition of glutamine, l-arginine and oxandrin also may help in the healing process.
Glutamine, an amino acid that promotes lymphocyte production and macrophage function, is essential for protein synthesis during stress states. During periods of physiological stress, it cannot be produced at an adequate rate.
l-arginine supports collagen formation and is necessary for healing. It also stimulates insulin secretion, promotes the transport of amino acids into tissue cells and supports the formation of protein in the cells. During illness and periods of metabolic stress, the body is unable to produce it in sufficient amounts.
Although some studies related to wound healing in the use of both glutamine and l-arginine are controversial, there are other studies that have shown improved collagen synthesis in elderly patients who received a diet supplemented with both.
There are several supplements on the market containing these two amino acids, such as Arginaid Extra by Novartis and Juven by Ross. If a protein supplement is needed or if the wound fails to granulate for no known reason, these additives should be considered.
Oxandrin (oxandrolone) is an anabolic steroid that helps drive amino acids into cells. It may be indicated for patients who have lost greater than 10% lean body mass and is particularly beneficial to patients who fail to respond to nutritional replacement alone. Oxandrin needs to be given in conjunction with nutritional support, especially protein.
Consult a dietary professional before using supplements. You must consider contraindications and precautions.
Please send your wound treatment-related questions to Susan Wickard at [email protected].
From the May 01, 2011 Issue of McKnight's Long-Term Care News
