Wound Healing

Wound healing proceeds through haemostasis, inflammation, proliferation and remodelling, and each phase depends on adequate protein, oxygen delivery and micronutrient status. Protein-energy malnutrition is the most common nutritional cause of delayed healing in older and hospitalised patients. Vitamin C is required for collagen hydroxylation and zinc for cellular proliferation and immune function, but supplementing above sufficiency does not accelerate healing in replete people and high-dose zinc can impair it through copper depletion. Uncontrolled diabetes, smoking, arterial insufficiency and infection are the dominant clinical barriers. Non-healing wounds need assessment, not supplements.

1) Eat adequate protein — 1.2-1.5g per kg body weight, and more with significant wounds — since protein deficit is the most common nutritional barrier. 2) Control blood glucose, as hyperglycaemia impairs immune function and collagen deposition. 3) Stop smoking, which causes vasoconstriction and reduces tissue oxygen delivery. 4) Keep wounds appropriately moist and covered; moist wound healing outperforms drying out. 5) Correct documented zinc or vitamin C deficiency rather than supplementing speculatively. 6) Ensure adequate energy intake, since catabolism diverts protein from repair. 7) Address arterial insufficiency and pressure offloading, common causes of chronic wounds. 8) Seek clinical review for any wound not improving in two weeks or showing signs of infection.

• •Adequate protein intake
• •Glycaemic control
• •Smoking cessation
• •Moist wound care
• •Correcting documented deficiencies
• •Sufficient energy intake
• •Pressure offloading and vascular assessment