Role of enzyme bromelain and micronutrients in wound healing

Healing of wounds, involves the activity of an intricate network of blood cells, tissue types, cytokines, and growth factors. This results in increased cellular activity, which causes an intensified metabolic demand for nutrients. Nutritional deficiencies can impede wound healing, and several nutritional factors required for wound repair may improve healing time and wound outcome.

Nutritional supplementation in the period before and after surgery can have a significant impact on surgical outcome by reducing bruising, swelling, and inflammation, promoting wound healing, enhancing immunity, and reducing oxidation generated by surgery and anesthetic agents, with consequent reduction in patient recovery time.

As there is an increase in nutritional needs in hyper metabolism and organic disorders, the nutrient requirements are often not satisfied with traditional food, and supplements become necessary. Anesthetic agents are a considerable source of oxidation, causing the formation of reactive oxygen, which inflicts damage to tissues and the healing process. The excess of free radicals has several harmful effects, such as immunity suppression, altered cellular function, increase in lipid peroxidation, and inadequate interaction of the nutrients that form collagen, which, in turn, causes loss of tissue flexibility.

Under this system, nutrition is considered a major factor as many nutrients can influence the healing phases because of their involvement in the synthesis of new tissues, suppression of oxidation, healing optimization, and also in immune competence.

Vitamin C
Vitamin C supplementation is highly recommended since Vitamin C promotes healing by various mechanisms including partaking an essential role in collagen formation, providing support for the immune system, and acting as a tissue antioxidant and free-radical scavenger. Ascorbic acid is an essential cofactor for the synthesis of collagen, proteoglycans, and other organic components of the intracellular matrix of tissues such as bones, skin, capillary walls, and other connective tissues. Ascorbic acid deficiency causes abnormal collagen fibers and alterations of the intracellular matrix that manifests as cutaneous lesions, poor adhesion of endothelium cells, and decreased tensile strength of fibrous tissue.

Vitamin B
Vitamin B complex is thought to have many benefits and is particularly known for its integral role in energy productions and has just recently been recognized for its benefits in the healing process. It is integral to all major wound healing processes. Vitamin B is thought to speed up wound healing, increase protein synthesis and the number of repair cells at the wound, prevent excessive inflammation, protect against oxidative stress, and increase tissue blood flow.

Vitamin A
Vitamin A is required in cell growth (especially tissue and bone formation), which is very important in the healing process that takes place after surgery and injuries. It is known to activate production of connective tissue, including collagen (promotes tissue synthesis), and helps new blood vessels grow, which is necessary for nourishing newly formed tissue. It increases collagen cross-linking and wound breaking strength. Vitamin A increases the initial inflammatory response in wounds, thus facilitating the migration of cells that assist with wound healing at the cite. Importantly, it reverses corticosteroid-induced inhibition of cutaneous wound healing.

Bromelain
Bromelain reduces inflammation, swelling, bruising and pain after surgery and physical injuries, as well as healing time.

Zinc
Zinc is a cofactor of many enzymes, including some that are needed to repair wounds. It is also an antioxidant and has significant antibacterial properties. Even a mild deficiency of zinc can interfere with optimal recovery from everyday tissue damage and more serious trauma.

Selenium
Selenium has strong antioxidant roles. There is some suggestion that it may expedite wound healing in burn patients. The antioxidant properties of selenium benefit wound healing.

Iron
Iron serves as a cofactor in collagen synthesis.

Copper
Copper has a complex role in various cells, modulating several cytokines and growth factor stages of the wound healing process.

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