Time to wound closure in trauma patients with disorders in wound healing is shortened by supplements containing antioxidant micronutrients and glutamine: A PRCT

Background & aims: : We hypothesize that wound closure in trauma patients with disorders in wound healing is accelerated by supplementation of antioxidant micronutrients and glutamine. Methods: In a randomized, double-blind, placebo-controlled trial, 20 trauma patients with disorders in wound healing were orally supplemented with antioxidant micronutrients (ascorbic acid, alpha-tocopherol, beta-carotene, zinc, selenium) and glutamine (verum) or they received isoenergetic amounts of maltodextrine (placebo) for 14 days. Plasma/serum levels of micronutrients, glutamine, and vascular endothelial growth factor-A (VEGF-A) were determined before and after supplementation. In the wound, several parameters of microcirculation were measured. Time from study entry to wound closure was recorded. Results: Micronutrients in plasma/serum did not change except for selenium which increased in the verum group (1.1 +/- 0.2 vs. 1.4 +/- 0.2 mu mol/l; P = 0.009). Glutamine decreased only in the placebo group (562 +/- 68 vs. 526 +/- 55 mu mol/l; P = 0.047). The prevalence of hypovitaminoses and the concentration of VEGF-A did not change. Considering microcirculation, only O-2-saturation decreased in the placebo group (56.7 +/- 23.4 vs. 44.0 +/- 24.0 [arbitrary units]; P = 0.043). Wound closure occurred more rapidly in the verum than in the placebo group (35 +/- 22 vs. 70 +/- 35 d; P = 0.01). Conclusions: Time to wound closure can be shortened by oral antioxidant and glutamine containing supplements in trauma patients with disorders in wound healing. (c) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.