Proper wound healing requires sufficient dietary protein intake. Protein inadequacy impedes wound healing by prolonging the inflammatory phase; impairing fibroplasias, collagen, and proteoglycan syntheses; and impairing wound remodeling.2122 Animals consuming diets deficient in protein demonstrated decreased wound integrity and strength compared to animals receiving adequate dietary protein.23 Additionally, protein-deficient animals experienced impaired collagen deposition, decreased skin and fascial wound breaking strength, and increased wound infection rates.23
A clinical trial assessing wound healing among subjects of varying nutritional states showed that subjects with low serum protein (< 6.5 g/dl) or serum albumin (< 3.5 g/dl) levels had decreased wound strength compared to those with higher serum protein and (> 6.5 g/dl) serum albumin (> 3.5 g/dl) levels.24 Surgical patients with mild protein-energy malnutrition (defined as 90 to 95% usual body weight) or severe protein-energy malnutrition (defined as < 90% usual body weight) had lower healing rates compared to well-nourished patients. Specifically, patients with protein-energy malnutrition produced less hydroxyproline compared to well-nourished patients.25
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