Helping Wounds Heal With Amino Acids

Nancy Collins, PhD, RDN, LD, NWCC, FAND

The use of targeted amino acids is becoming more common as a strategy to help heal a variety of conditions, including wounds, because of the role key amino acids have in rebuilding tissue.

Helping Wounds Heal With Amino Acids

 

Chronic wounds, meaning those that have not healed in 12 weeks, affect approximately 6.5 million patients in the United States annually at a cost of $25 billion.1 The term chronic wound refers to various types of skin integrity problems, such as pressure injuries, diabetic foot ulcers, venous ulcers, arterial ulcers, burns, and traumatic wounds to name a few.

The Role of Nutrition

Dr Nancy Collins

Nancy Collins, PhD, RDN, LD, NWCC, FAND

Nutrition often is not the first thing you think of when talking about wounds, but it is important to understand the link between poor nutrition and wound healing. Essentially, when a body has a wound, it has competition for the nutrients it needs. Wound healing is very energy dependent; energy is another word for calories. If your patient is not eating well and not meeting his or her caloric and protein goals every day, weight loss typically occurs.

When nutritional substrate is in short supply, the body decides whether to use the available substrate to build new tissue for the wound or to use it to keep its vital organs functioning. If weight loss continues unchecked, wound healing is impaired and eventually it will cease altogether in favor of the body’s vital organs.2

Timely Nutrition Intervention

Prompt nutrition intervention is needed, as well as action to fill any nutritional gaps. If your patient is not eating well in general, oral nutritional supplements, such as Ensure® Enlive® (Abbott Nutrition, Columbus, OH), are good sources of additional protein and calories. It is important to halt any further weight loss.

In addition, healthcare professionals can take nutrition intervention a step further for wounds by supplementing targeted amino acids specifically to support tissue building. Many amino acids are known to have a role in building and repairing body tissues, but the main focus is on arginine, glutamine, and a bioactive metabolite of leucine called ß-hydroxy-ß-methylbutyrate or HMB for short.

Functions of Amino Acids

Arginine is an amino acid that supports blood flow and is a building block for proteins.3

Glutamine is an amino acid that plays a role in the production of collagen, the main structural protein in skin and other connective tissues, and supports the immune system.4,5

HMB is a compound found in small amounts in the body and in small amounts in certain foods, such as grapefruit, alfalfa, and catfish. HMB helps produce new tissue by slowing muscle breakdown and enhancing protein synthesis.6

 

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Supplementation of Amino Acids

Juven® (Abbott Nutrition, Columbus, OH) is a nutritional supplement that contains the efficacious amounts of arginine, glutamine, and HMB to support tissue building in 2 weeks.7 Juven also contains collagen protein to stimulate collagen production and is shown to accelerate the rate of wound healing.8,9 In addition, it also contains zinc and vitamins C, E, and B12, which are all important micronutrients for the wound healing process. These micronutrients may aid in improving immune response, improving skin integrity, and boosting collagen synthesis.10

It is recommended that patients with wounds receive two packets of Juven per day. Juven comes in powdered form to keep the amino acids active and is easily mixed with 8-10 fluid ounces of water or fruit juice. Juven is a clear, light beverage that patients can receive on their meal trays as their beverage, thereby encouraging full consumption and easy adherence. It’s available in orange and fruit punch flavors, as well as unflavored to mix in foods for patients with fluid restrictions.

 Call to Action

If you are not already using amino acids, go ahead and try them on a hard-to-heal patient. I would love to hear about the results you experience. Write me at www.drnancycollins.com.

Nutrition Wound Care Certification

Are you an RD or RDN interested in becoming board certified in wound care?  Click here to learn about the Skin and Wound Management course with Nutrition Wound Care Certified (NWCC) exam, or visit the blog “Discover the Benefits of Wound Care Nutrition Certification“.

 

References

  1. Sen CK, Gordillo GM, Roy S, et al. Human skin wounds: a major and snowballing threat to public health and the economy. Wound Repair Regen. 2009;17(6):763-771. doi:10.1111/j.1524-475X.2009.00543.x.
  2. Demling RH. Nutrition, anabolism, and the wound healing process: an overview. Eplasty. 2009;9:e9.
  3. Stechmiller JK, Childress B, Cowan L. Arginine supplementation and wound healing. Nutr Clin Pract. 2005;20(1):52-61.
  4. Bellon G, Chaquor B, Wegrowski Y, Monboisse JC, Borel JP. Glutamine increases collagen gene transcription in cultured human fibroblasts. Biochim Biophys Acta. 1995;1268(3):311-323.
  5. Andrews FJ, Griffiths RD. Glutamine: essential for immune nutrition in the critically ill. Br J Nutr. 2002;87(suppl 1):S3-S8.
  6. Wilson GJ, Wilson JM, Manninen AH. Effects of beta-hydroxy-beta-methylbutyrate (HMB) on exercise performance and body composition across varying levels of age, sex, and training experience: a review. Nutr Metab (London). 2008;5:1. doi:10.1186/1743-7075-5-1.
  7. Williams JZ, Abumrad N, Barbul A. Effect of a specialized amino acid mixture on human collagen deposition. Ann Surg. 2002;236(3):369-375.
  8. Lee SK, Posthauer ME, Dorner B, Redovian V, Maloney MJ. Pressure ulcer healing with a concentrated, fortified, collagen protein hydrolysate supplement: a randomized controlled trial. Adv Skin Wound Care. 2006;19(2):92-96.
  9. Sugihara F, Inoue N, Koizumi S, Sriraam VT. Collagen hydrolysate enhanced pressure ulcer healing in a randomized double-blind placebo-controlled study. Jpn Pharmacol Ther. 2015;43(9):1323-1328.
  10. Molnar JA, ed. Nutrition and Wound Healing. Boca Raton, FL: CRC Press; 2007:5.

 

About the Author: Nancy Collins, PhD, RDN, LD, NWCC, FAND, is a registered dietitian nutritionist with expertise in wound care, malnutrition, and medico-legal issues. Dr. Collins strives to improve patient outcomes and patient satisfaction through better communication. To contact her, visit her website, www.drnancycollins.com.

Wound Care Education Institute® provides online and onsite courses in Skin & WoundDiabetic and Ostomy Management. Eligible clinicians may sit for the prestigious WCC®, DWC® NWCC and OMS national board certification exams through the National Alliance of Wound Care and Ostomy®(NAWCO®). For details, see wcei.net.

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Amino acids play a role in building and repairing body tissues. As a result, health care professionals are increasingly using supplementation to support the healing of chronic wounds. Dr. Nancy Collins discusses the role of nutrition in wound care and identifies three key amino acids for healing.

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