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Oral Nutritional Supplementation Accelerates Skin Wound Healing: A Randomized, Placebo-Controlled, Double-Arm, Crossover Study

Brown, Spencer A. Ph.D.; Coimbra, Maria M.D.; Coberly, Dana M. M.D.; Chao, James J. M.D.; Rohrich, Rod J. M.D.

Plastic & Reconstructive Surgery: July 2004 - Volume 114 - Issue 1 - pp 237-244
doi: 10.1097/01.PRS.0000128818.28425.52

Nutritional therapy is critical for wound healing in people with severe malnutrition or specific metabolic deficiencies. Medical claims from manufacturers of many oral supplements are marketed to surgical patients for decreasing edema, bruising, and discomfort. The effect of supplementing nutrients on soft-tissue wound healing in otherwise normal, healthy adults is an area of clinical importance, but little information is available. Proteolytic enzymes have been reported to moderate the inflammatory cycle and may up-regulate the healing process. The goal of this study was to perform a clinical trial in normal, healthy adults that examined the effects of an oral nutritional supplement (InflammEnz, Enzymes, Inc., Parkville, Mo.) on soft-tissue healing times. Twenty-six normal, healthy volunteers were recruited into a randomized, crossover, placebo-controlled, clinical trial consisting of two phases, each lasting 21 days. In phase I, subjects were subjected to a 3-mm forearm skin biopsy and randomly received a placebo or oral supplement (four capsules per day for 7 days). After a 2-week washout period, a second biopsy was performed to start phase II, with each subject receiving the respective placebo or supplement capsules. Digital photographs were taken during wound healing in both phases and analyzed for wound areas (in square millimeters) and perimeters (in millimeters). Twenty-two subjects completed the clinical trial. On the basis of wound surface areas, 17 subjects had improved wound healing and five subjects did not respond or responded only slightly to the supplement treatment. The mean ± SD healing time of the subjects responding to supplement-treated wounds was 15 ± 2.2 days, compared with 18 ± 2.5 days for the placebo group. The 17 percent acceleration of wound-healing time was significant (p < 0.005). In subjects responding to oral supplements, less redness in the wounds was observed that may have been associated with less inflammation. The authors’ results demonstrate that InflammEnz oral supplementation accelerated soft-tissue wound healing in 77 percent of normal, healthy subjects studied. The authors’ study validates observations made that this supplement modulates the wound-healing process and suggests that many patients with minor soft-tissue wounds may benefit from treatment.

Dallas, Texas

From the Nancy L. and Perry Bass Advanced Wound Healing and Tissue Regeneration Laboratory, Department of Plastic Surgery, University of Texas Southwestern Medical Center.

Received for publication May 22, 2003; revised November 26, 2003.

Rod J. Rohrich, M.D., Department of Plastic Surgery, University of Texas Southwestern Medical Center, 5325 Harry Hines Boulevard, E7.212, Dallas, Texas 75390-9132,

©2004American Society of Plastic Surgeons