Wound Healing

Judy Seybold, MS, RDN, LD, CLC
Chief Nutrition Officer


Have you ever stopped to think how that paper cut on your finger heals? We may take wound healing for granted since it just happens on its own over a course of time. But the mechanism of wound healing is a highly complex series of events that the body orchestrates.

Once a person has been injured with a resulting wound, the body goes through a series of four main steps to initiate healing.

Stop the bleeding

A cut, scrape, or puncture is usually followed by bleeding. Blood cells start to clump together and form a clot to stop the bleeding. These clots turn into scabs as they dry and form a net, fibrin, to hold the clot in place.

Certain medicines can interfere with clotting. Anticoagulants inhibit blood clotting and are used for people at higher risk for developing blood clots. There are medicines that can interfere with anticoagulants or increase the effect of anticoagulants. In addition to medicine, vitamin K can affect anticoagulants. It is recommended to keep vitamin K intake consistent when taking anticoagulants as they promote blood clotting. Some foods and beverages high in vitamin K include broccoli, cabbage, cheese, green tea, kale, lettuce, spinach, and soybean oil.

Inflammation

Blood vessels open up to allow nutrients and oxygen into the wound area to promote healing once the wound is closed with a clot. Macrophages, white blood cells that protect the wound, help fight infection and oversee the repair process. They also produce growth factor to help repair the wound. In addition, you may notice a clear fluid around a wound that serves to clean the area.

Growth and rebuilding

Blood cells arrive at the site of the wound to help rebuilding. Chemical signals instruct cells to create collagen along with other tissues to begin the repair process. A scar may result as part of this process.

Strengthening

The new tissue gets stronger as time goes on. Stretching, itching, and puckering of the wound may happen during this time. It takes almost 3 months for the wound to be as strong as it was before the trauma. Wounds usually heal significantly in 4 to 6 weeks. But the entire healing process for some wounds can take a couple of years to complete.

Factors affecting healing

There are factors that can interfere with wound healing. If there is a reduced or inadequate blood supply to the wound, it can take twice as long to heal or may not heal completely. Wounds that don’t heal are called chronic wounds and may affect up to 6.5 million people in the United States. These types of wounds are more prevalent in people with diabetes, high blood pressure, obesity, or vascular disease. In addition, elderly people can suffer from poor wound healing especially if they are confined to a bed or wheelchair.

Healing can also be adversely affected by medications such as anticonvulsants, steroids, antibiotics, angiogenesis inhibitors, and NSAIDs. On the other hand, there are drugs known to promote healing, which include insulin, vitamins, thyroid hormone, and iron.

Stem cells are on the frontier of wound healing. But ethical issues still remain regarding the widespread use of this technology and differing opinions on the efficacy.

Healthy eating tips

Most wounds will heal on their own without incidence. Healthy eating can help promote wound healing by providing the necessary energy, vitamins, minerals, and protein needed. Here are some tips to promote wound healing with proper nutrition.

  • Eat a balanced diet that includes less-processed foods and plenty of fruits, vegetables, protein, and whole grains.
  • Stay hydrated with water or unsweetened beverages.
  • Control blood glucose levels if you have diabetes.
  • Choose fruits and vegetables rich in vitamin C and potassium.
  • Choose whole grains and eggs, meat, dairy, or seafood for adequate amounts of zinc.
  • Include a source of protein at each meal and snack. Protein is important.

Adequate protein intake is especially important with wound healing. Your needs per day are greater depending on the severity of the wound, your size, healing time, and your health status. Regardless, try to focus on getting a serving of protein at each meal and snack. Here’s what counts as a serving:

  • 1 ounce of meat, including beef, pork, poultry, or seafood
  • 1 ounce of cheese
  • 1/4 cup cottage cheese
  • 1 ounce of nuts
  • 2 tablespoons of peanut butter
  • 1 egg
  • 1/2 cup beans or legumes
  • 1 cup milk
  • 6 ounces of regular yogurt
  • 3 ounces of Greek yogurt

Make sure to follow up with your doctor if you have a wound that is not healing in a reasonable time frame. Work with a registered dietitian to develop a meal plan that promotes wound healing.


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Additional Resources

Academy of Nutrition and Dietetics
Johns Hopkins Medicine