Vitamins, wound healing

Panthenol is frequently used in ointments and solutions for the treatment of burns, anal fissures, and inflammation of the conjunctiva. The vitamin has to be substituted in patients on total parenteral nutrition and in those who regularly undergo dialysis. Hypervitamin-osis has not been observed for doses up to 5 g/d (22). Furthermore, the administration of pantothenic acid leads to improved surgical wound healing due to its antiinflammatory properties. 

Bartlett MK, Jones CM, Ryan AE (1942) Vitamin C and wound healing II.. corbie acid content and tensile strength of healing wounds in human beings. N EngJ J Med 226 474-481... 

Deficiency symptoms In vitamin C deficiency scurvy develops. It is characterized by ecchymosis, petechiae, swollen and bleeding gums, subperiosteal haemorrhage, bones are painful to touch, impaired wound healing, anaemia, loosening of teeth and gingivitis. 

The active form of vitamin C is ascorbate acid (Figure 28.8). The main function of ascorbate is as a reducing agent in several different reac lions. Vitamin C has a well-documented role as a coenzyme in hydroxy lation reactions, for example, hydroxylation of prolyl- and lysyl-residues of collagen (see p. 47). Vitamin C is, therefore, required for the mainte nance of normal connective tissue, as well as for wound healing. Vitamin C also facilitates the absorption of dietary jron from the intestine. 

Vitamin C (ascorbic acid) functions as an antioxidant and as a cofactor for hydroxyla tion reactions in procollagen. A deficiency of vitamin C results in scurvy, a disease char acterized by sore, spongy gums, loose teeth, and poor wound healing. There is no known toxicity for this vitamin. 

A partial list of physiological functions til at have been determined to be affected by vitamin C deficiencies includes (1) absorption of iron (2) cold tolerance, maintenance of adrenal cortex (3) antioxidant (4) metabolism of tryptophan, phenylalanine, and tyrosine (5) body growth (6) wound healing (7) synthesis of polysaccharides and collagen (8) formation of cartilage, dentine, bone, and teeth and (9) maintenance of capillaries. 

Abstract The utility of confocal Raman microscopy to study biological events in skin is demonstrated with three examples, (i) monitoring the spatial and structural differences between native and cultured skin, (ii) tracking the permeation and biochemical transformation in skin of a Vitamin E derivative and (iii) tracking the spatial distribution of three major skin proteins (keratin, collagen, and elastin) during wound healing in an explant skin model. 

There are some well-described deficiency syndromes, the well-established therapeutic use of vitamin K antagonists as oral anticoagulants and the well-known positive effects of pantothenic acid on skin hydration/moisturization and wound healing, which apparently lacks scientific solid base. Apart from that there are not many studies available on the treatment of dermatological disorders with these vitamins, either systemically or topically. Even less is known about transdermal penetration, stability, and formulation dependencies of possible topical applications. 

Vitamin E (a-tocopherol) is most abundantly available in wheat germ oil and in small quantities in cereals, nuts, spinach, and egg yolk. Deficiency of vitamin E normally does not occur. Large doses of vitamin E are used to reduce the toxicity of vitamin A. Prolonged use causes delay in wound healing but significant... 

The richest sources of vitamin C are citrus fruits (e.g., lemon, oranges), tomatoes, potatoes, green chilies, and human milk. Severe deficiency causes scurvy and is prevalent in malnourished infants, children, adults, alcoholics, and drug addicts. Symptoms such as bleeding gums, deformed teeth, brittle bones, impaired wound healing, anemia, and growth retardation are observed. 

Egger SF, Huber-Spitzy V, Alzner E, Scholda C, and Vecsei VP (1999) Corneal wound healing after superficial foreign body injury vitamin A and dexpanthenol versus a calf blood extract. A randomized double-blind study. Ophthalmologica 213, 246-9. 

Vaxman F, Olender S, Lamhert A, Nisand G, and Grenier JF (1996) Can the wound healing process he improved hy vitamin supplementation Experimental study on humans. European Surgery Research 28,306-14. 

Weimann BI and Hermann D (1999) Studies on wound healing effects of calcium D-pantothenate on the migration, proliferation and protein synthesis of human dermal fibroblasts in culture. International Journal of Vitamin and Nutrition Research 69, 113-19. 

Epidermal keratinization and mucous membrane squamous metaplasia respond to both oral and topical vitamin A therapy. Vitamin A exists in three forms retinol, retinal, and retinoic acid.VitaminA increases the mucous production of goblet cells and perhaps the aqueous and lipid components of the tears as well. Tretinoin is a normal metabolite and the carboxylic form of retinol. Retinol is present in tears and the lacrimal gland appears to be its major provider. Retinoic acid has been shown to be effective in ocular surfece disorders such as squamous metaplasia by reversing the corneal and conjunctival keratinization and improving epithelium wound healing rate. 

Ascorbic acid (Vitamin C) Vegetables and citrus fruits Sore gums, loose teeth, joint pain, edema, anaemia, fatigue, depression, impaired iron absorption, impaired wound healing. 

The most important reaction requiring ascorbate as a cofactor is the hydroxylation of proline residues in collagen. Vitamin C is, therefore, required for the maintenance of normal connective tissue as well as for wound healing since synthesis of connective tissue is the first event in wound tissue remodeling. 

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