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Health Protocols

Trauma and Wound Healing

Physical trauma elicits profound physiological responses (Goldman 2016). Whether the cause of injury is accidental or intentional, such as in the case of surgery, the healing process is complex and frequently imperfect. For example, the body’s attempt to maximize tissue integrity after an injury often results in scar formation. In addition, wounds such as pressure ulcers can occur in immobilized or hospitalized patients, and may persist for months without healing (Sidgwick 2015). Improving wound care outcomes is a focal point of much ongoing research.

Conventional wound care relies heavily on topical treatment with antimicrobials, protective barriers, and tissue-growth-promoting agents, as well as tissue grafts. Nutrition plays an important and sometimes underappreciated role in successful wound healing. During the healing process, some nutrients important for wound repair, such as glutamine, may become conditionally essential. Furthermore, suboptimal nutrition and malnourishment, which are common in those with chronic or slow healing wounds, can undermine the physiological processes that promote wound closure and tissue regeneration. Thus, a well-balanced diet providing adequate protein, along with targeted nutritional supplementation, may improve wound healing (Quain 2015).

Ongoing wound care research continues to identify novel modalities for enhancing wound healing. For instance, bacteriophages, which are viruses that infect bacteria, represent an intriguing approach to treating wound infections while minimizing antibiotic resistance (Fish 2016), and temporary use of locally applied insulin may be an affordable alternative to expensive growth factors sometimes used to promote wound healing (Oryan 2017).

Several integrative interventions may also be useful in supporting wound healing. Omega-3 fatty acids may help regulate the inflammatory response at the site of injury, thereby enhancing tissue repair while reducing inflammatory tissue damage (Kiecolt-Glaser 2014). The citrus flavonoids diosmin and hesperidin have been shown in several studies to help heal chronic ulcers related to circulatory problems in the legs (Coleridge-Smith 2005).

This protocol summarizes usual wound-treatment strategies and reviews several important dietary and nutritional considerations to further support healthy wound healing. It also describes a number of novel and emerging wound-treatment techniques.