Vitamin C status of patients with non-healing wounds

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Status: In-progress
Year: 2019
Funded: $74,262
Grant Type: Major Project Grant
Free Radicals

Non-healing wounds are common and negatively affect quality of life, causing pain and limiting movement and social interaction. Their management is also a significant burden on health resources, and any improvement in wound healing would be a significant advantage for patients, and the health budget.

Vitamin C is essential for wound healing, promoting collagen synthesis and normal tissue remodelling. However, the vitamin C status of individuals with chronic wounds is poorly understood. Poor nutrition and, in particular, a low vitamin C status are common in the general population and often exacerbated when people are unwell. Low vitamin C status may contribute to impaired wound healing and dietary supplementation would be a cost-effective and simple adjunct treatment option.

Such clinical advice requires a sound factual basis and therefore we propose to conduct a cross-sectional study to determine the vitamin C status of patients referred to the Nurse Maude Wound Management Service in Christchurch. In addition, wound size will be determined using the Silhouette laser wound scanner. This will allow us to compare the vitamin C status of patients with different wound classes, size and duration. This information will contribute to the design of a future vitamin C intervention study.

Researcher // Dr Juliet Pullar – University of Otago

Dr Pullar is currently involved in undertaking human studies investigating the bioavailability of vitamin C and its role in health and disease.

More About Dr Juliet Pullar

Why Vitamin C?

Vitamin C has many physiologic functions in the human body. It is often aligned with wound healing because of its role in collagen formation. Vitamin C is a co-factor in proline and lysine hydroxylation, a necessary step in the formation of collagen. Hydroxyproline and hydroxylysine are essential for stabilizing the triple helix structure of collagen with strong hydrogen bonds and crosslinks. Without this stabilization, the structure disintegrates rapidly. Vitamin C also provides tensile strength to newly built collagen; otherwise, new tissue could not stretch without tearing. Tensile strength is important in pressure ulcer healing because healed pressure ulcers are susceptible to future skin breakdown. Vitamin C also is required for proper immune system function, a consideration in patients with open wounds.

Other chief functions of vitamin C include:

  • antioxidant to inhibit damage to body cells
  • anti-inflammatory
  • necessary for the synthesis of carnitine, a molecule essential for the transport of fat to mitochondria
  • plays a role in the synthesis of the neurotransmitter norepinephrine
  • protects iron in the intestines from oxidation and promotes absorption
  • protects vitamin E in the blood from oxidation and may recycle it to its active form.

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