Each of us requires a number of essential nutrients to achieve optimum health. However, because most of us do not follow a well-balanced diet on a consistent basis, we often do not obtain the nutrients that our bodies need. This becomes of paramount importance during the times of stress, trauma, injury and surgery. Procare is a novel blend of high-quality essential nutrients that have been scientifically shown to enhance the healing status and the body’s defense system. It contains a scientifically formulated blend of essential elements that are needed for optimal DNA and protein synthesis, cellular proliferation, wound healing and immune function.
Protein deficiency impairs wound healing since protein is needed for fibroblast proliferation, new blood vessel formation, and collagen production. Protein deficiency leads to impaired healing through impaired collagen synthesis and deposition, decreased skin and fascial wound-tensile strength (Spanheimer et al., 1985; Irvin 1978). Haydock and Hill (1986) have reported significantly lower healing rates in patients with protein deficiency. In addition to the clear role of protein intake in wound healing, proteins are essential to function of the immune system. Severe protein deficiency has been associated with a greater risk for infection (Schneider et al., 1983). These immune compromises correlate clinically with increased wound complication rates and increased wound failure after clean surgical procedures (Kay et al., 1987; Dickhaut et al., 1984; Casey et al., 1983).
The protein RDA for healthy adults is 0.8 g/kg body weight. A higher protein intake is desirable during the time of stress and extensive wound healing. Several studies have shown that higher protein intakes, ranging between 1.25 (Bergstrom et al., 1994) to 2.1 ± 0.9 g protein/kg body weight (Breslow et al., 1993) can enhance the healing process.
Arginine is one of two semiessential amino acids and involved in collagen synthesis of the healing wounds. At times of stress or injury, arginine synthesis is insufficient to meet the demands of increased protein turnover and the body arginine stores decrease rapidly. It is during these times that arginine becomes an indispensable amino acid in the process of wound healing (Rose, 1949; Seifter et al., 1978). Arginine contributes to the wound healing process and stimulation of the immune response in multiple ways:
Glutamine plays significant roles in wound healing as a major precursor source in glucose formation, amino acids synthesis, and nucleotide synthesis in cells. Glutamine's benefit appears to involve improvements in protein synthesis and decreased hospital stay.
Vitamin A/Beta carotene
Vitamin A plays an important role in the wound healing process and body’s immune response. Vitamin A increases macrophage influx and activation into the wounds, stimulate fibroblast to synthesize collagen, and augments cellular proliferation (Conner, 1986; Demetriou et al., 1985; Niu et al., 1987, Patel, 2005). Furthermore, it functions as an immunostimulant by increasing the number of white blood cells, monocytes and macrophages in the wound (Cohen et al., 1979; Barbul et al., 1978; Ehrich and Hunt, 1968).
Vitamin C, or ascorbic acid, is an essential water-soluble nutrient that plays a role in wound healing by increasing collagen and elastin synthesis (Goetzl et al., 1974 ; Nicosai et al., 1991). Vitamin C also enhances white blood cell, neutrophil, function (which helps prevent infection) and increases the synthesis of blood vessels that supply the new skin tissues with nutrients (Goetzl et al., 1974; Nicosai et al., 1991). Vitamin C deficiency is associated with capillaries leakage due to decreased collagen production and susceptibility to wound infections. These effects are thought to be attributable to impaired collagen synthesis as well as impairment of immune system function. In humans, vitamin C supplementation has been shown to produce wound healing rates up to 50% faster in oral surgery. Thiamine
Thiamine plays an essential role in the metabolism of carbohydrates and branched-chain amino acids (Tanphaichtr and Thiamin, 1994) and thus is an important factor in collagen synthesis and the healing process.
B12 and Folate
Given the importance of vitamin B12 and folate in DNA synthesis, a severe deficiency of these vitamins can potentially contribute to poor wound healing.
Zinc is required for multiple aspects of wound healing including, normal nucleic acid metabolism, DNA synthesis, protein synthesis, synthesis of structural proteins such as collagen, the function of several hundred enzymes, and for normal insulin-like growth factor (IGF-1) production. Hallbook and Lanner (1972) demonstrated that zinc supplementation improves wound healing in zinc deficient patients. Zinc also plays an important role in supporting the immune system. Immune system functions are impaired in zinc deficiency, resulting in an increased susceptibility to wound infection and a resultant increased possibility of delayed healing (Prasad, 1993). Girodon et al (1997) have shown that patient receiving zinc + selenium experienced less infections at 2 yeras (Girodon et al., 1999).
Although, no clinical consequences of selenium deficicency are noted, this trace element is important for thyroid function, muscle metabolism (Amaral et al., 1985), as well as immune function (Roy et al., 1990).
Iron plays an important role in wound healing by participating in oxygen transport and collagen production. Patients with iron deficiency may present with low red blood cell count, generalized fatigue, weakness and a feeling of being overtly tired. Any iron deficiency should be clearly treated and most patients would benefit from pre-operative oral iron supplementation.
Many forms of anesthesia put significant strain on the antioxidant system, including changes in serum vitamin E levels, development of increased number of free radicals, and increased lipid peroxidation. Antioxidants play an especially important role in health. Antioxidants provide protection against free-radical damage. Loosely defined, a free-radical is a highly reactive molecule that can bind to, and destroy body components. Antioxidant nutrients like Vitamin C, Vitamin A, selenium, copper, manganese are very important in providing protection against free-radical damage. It is believed that antioxidants play an important role in wounded tissue protection, in providing protection against the development of heart disease, cancer, and other chronic degenerative diseases. Based on extensive data, it appears that a combination of antioxidants provide greater antioxidant protection than any single antioxidant. Therefore, in addition to recommending that individuals consume a diet rich in plant foods, especially fruits and vegetables, ProCare provides a combination of antioxidant nutrients that can diminish the free-radial damage of the surgical site.
Statements made herein have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.