SCAR ISSUE
To heal, wounds need proper nourishment
EVELINE GAN, eveline@mediacorp.com.sg
FOR those who think that good care and time are the main things that help heal wounds, think again.
According to American surgeon Dr Annabel Barber, who specialises in hard-to-heal wounds, successful healing requires plenty of nourishment from the right diet.
This is especially so for those with diabetic or pressure ulcers, burn or trauma injuries, or surgical wounds.
“When a wound doesn’t heal as it should, malnutrition could be one of the reasons,” said Dr Barber, chief of General Surgery Clinics at the University Medical Center, Las Vegas, Nevada. She was in Singapore for a symposium on tissue regeneration last month.
Typically, new blood vessels and skin cells take about two to three weeks to form over a wound. Without adequate nutrition, the healing process can be prolonged. Other factors such as infection, smoking, diabetes and poor blood circulation can also impair the wound healing process.
Each day, the body requires a number of calories to function. For a wound to heal properly, the body would require more nutrients and calories, explained Ms Nehal Kamdar, a dietician at Raffles Hospital.
In most cases, a regular, balanced diet with an increased calorie and protein intake would be sufficient for normal wound healing. But for those with complex non-healing wounds, nutritional supplements maybe required in addition to a healthy diet, said Dr Barber.
An average-sized Singaporean adult requires about 2,000 to 2,550 calories, and 58 to68 grammes of protein daily.
Those with hard-to-heal wounds would need to consume about 20 per cent more calories than their recommended daily calorie intake.
They also require twice the recommended requirement of protein, according to Dr Barber.
She added that studies have also shown that certain amino acids found in protein — such as arginine and glutamine — have also been shown to be beneficial in healing problematic wounds.
Increasing the intake of vitamins A, C and E, fats and zinc may also help with the healing process.
People with wounds should also ensure they are well-hydrated, added Ms Kamdar.
She explained: “Dehydrated skin is less elastic, more fragile and more susceptible to breakdown. Dehydration also reduces the efficiency of blood circulation which will impair oxygen and nutrient supply to the wound.”
Ms Kamdar added that there is no magic figure when it comes to deciding how much nutrition works best. After all, each patient’s condition varies.
“A thorough assessment of the patient is necessary for effective nutrition intervention,” she said.
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The healing process.
Normal wounds go through three stages - the inflammatory phase, the proliferation phase, and the remodelling phase, said Dr Barber.
In the first stage, wound healing begins as blood clots and white blood cell count increases to fight bacteria in the wound.
By the end of the second stage, about two to three weeks later, new blood vessels, collagen and new skin cells would have formed over the wound.
In the last phase, which can last up to two years, the newly formed scar tissue flattens out and strengthens itself.
“Without adequate nutrients, wounds of malnourished patients can’t get from stage one to stage two of the healing process. They tend to get stuck in the inflammatory stage, prolonging the healing time,” explained Dr Barber.
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From TODAY, Health – Tuesday, 20-May-2009
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Want to clear a scar? Healing without scar?
To heal, wounds need proper nourishment
EVELINE GAN, eveline@mediacorp.com.sg
FOR those who think that good care and time are the main things that help heal wounds, think again.According to American surgeon Dr Annabel Barber, who specialises in hard-to-heal wounds, successful healing requires plenty of nourishment from the right diet.
This is especially so for those with diabetic or pressure ulcers, burn or trauma injuries, or surgical wounds.
“When a wound doesn’t heal as it should, malnutrition could be one of the reasons,” said Dr Barber, chief of General Surgery Clinics at the University Medical Center, Las Vegas, Nevada. She was in Singapore for a symposium on tissue regeneration last month.
Typically, new blood vessels and skin cells take about two to three weeks to form over a wound. Without adequate nutrition, the healing process can be prolonged. Other factors such as infection, smoking, diabetes and poor blood circulation can also impair the wound healing process.
Each day, the body requires a number of calories to function. For a wound to heal properly, the body would require more nutrients and calories, explained Ms Nehal Kamdar, a dietician at Raffles Hospital.
In most cases, a regular, balanced diet with an increased calorie and protein intake would be sufficient for normal wound healing. But for those with complex non-healing wounds, nutritional supplements maybe required in addition to a healthy diet, said Dr Barber.
An average-sized Singaporean adult requires about 2,000 to 2,550 calories, and 58 to68 grammes of protein daily.
Those with hard-to-heal wounds would need to consume about 20 per cent more calories than their recommended daily calorie intake.
They also require twice the recommended requirement of protein, according to Dr Barber.
She added that studies have also shown that certain amino acids found in protein — such as arginine and glutamine — have also been shown to be beneficial in healing problematic wounds.
Increasing the intake of vitamins A, C and E, fats and zinc may also help with the healing process.
People with wounds should also ensure they are well-hydrated, added Ms Kamdar.
She explained: “Dehydrated skin is less elastic, more fragile and more susceptible to breakdown. Dehydration also reduces the efficiency of blood circulation which will impair oxygen and nutrient supply to the wound.”
Ms Kamdar added that there is no magic figure when it comes to deciding how much nutrition works best. After all, each patient’s condition varies.
“A thorough assessment of the patient is necessary for effective nutrition intervention,” she said.
----------
The healing process.
Normal wounds go through three stages - the inflammatory phase, the proliferation phase, and the remodelling phase, said Dr Barber.
In the first stage, wound healing begins as blood clots and white blood cell count increases to fight bacteria in the wound.
By the end of the second stage, about two to three weeks later, new blood vessels, collagen and new skin cells would have formed over the wound.
In the last phase, which can last up to two years, the newly formed scar tissue flattens out and strengthens itself.
“Without adequate nutrients, wounds of malnourished patients can’t get from stage one to stage two of the healing process. They tend to get stuck in the inflammatory stage, prolonging the healing time,” explained Dr Barber.
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From TODAY, Health – Tuesday, 20-May-2009
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Want to clear a scar? Healing without scar?
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