Impaired Wound Healing in Surgical Patients with Varying Degrees of Malnutrition

Abstract

The relationship between nutritional state and wound healing was examined in 66 adult surgical patients. Wound-healing response was assessed by measuring the collagen content (hydroxyproline) of fine tubes of Gore-tex inserted subcutaneously along standardized needle track arm wounds. After a period of 7 days, the tubes were removed and it was found that there was a higher hydroxyproline content in the tubing of 36 normally nourished patients than there was in the tubing of 21 patients with mild protein energy malnutrition (p less than 0.01) and 9 patients with moderate to severe protein energy malnutrition (p less than 0.01). There was no difference in the wound-healing response between the two latter groups of patients who had significantly different degrees of malnutrition. The results suggest that a definite abnormality in the wound-healing response exists in malnourished surgical patients, but it occurs earlier in the course of the illness than previously supposed.

Changes in nutritional status associated with unresectable pancreatic cancer

“…This phenomenon may contribute further to the negative energy balance observed in such patients. Nutritional depletion is associated with reduced resistance to infection, muscle weakness and impaired healing (Bistrain et al, 1975;Haydock and Hill, 1986;Jeejebhoy, 1986). Moreover, progressive weight loss has been associated with profound effects on psychological state (Larsson et al, 1995).…”

Nutrition as a prognostic indicator in amputations

“…One explanation could be the high incidence of concomitant medical diseases in these patients. Wound healing response, assessed by measuring hydroxyproline over a 7-day period in fine thin-walled Gore-Tex tubes placed in the subcutaneous layers of the arm, was less in malnourished patients than in normally nourished patients (Haydock and Hill 1986). In several studies malnutrition has been correlated to impaired wound healing (Hill et al 1977, Warnold and Lundholm 1984, Katelaris et al 1986).…”

“…Patients with poor nutritional status appear to have an increased postoperative mortality, morbidity and rehabilitation time due to increased risk of infection, impaired wound-healing and muscle function following surgery (Law et al 1974, Buzby et al 1980, Chandra 1980, Bastow et al 1983a, Russell et al 1983, Haydock and Hill 1986, Katelaris at al. 1986.…”

Constipação intestinal em terapia intensiva

“…These patients may delay or even not meet the nutritional target intended for the enteral route. Inadequate nutrient intake leads to a worse prognosis because it reduces muscle strength and overall functional capacity (12) lessens the capacity to synthesize new tissue and wound healing (13)(14) increase the number of infections (15) as well as increases length of stay and morbidity and mortality. (16)(17) …”