W procesie leczenia ran niezwykle istotną rolę odgrywają makro- i mikroelementy, takie jak białko, węglowodany i tłuszcze, które wspierają funkcjonowanie układu odpornościowego i gojenie się ran. Taką funkcję pełnią również witaminy A, C, E oraz selen, miedź i cynk. Pacjentom z oparzeniami zaleca się także suplementację witaminy D.
Proces gojenia ran jest etapem złożonym i rozpoczyna się już w momencie powstania urazu. Może go zaburzać wiele czynników działających zarówno ogólnoustrojowo, jak i lokalnie. Jednym z nich są niedobory składników odżywczych. U pacjentów z ranami udokumentowano zwiększone zapotrzebowanie organizmu na cynk oraz witaminy A, C i E, natomiast u pacjentów z ciężkimi oparzeniami niedobór witaminy D.
Witaminy A i E należą do stymulatorów odbudowy tkanek
Witamina A jest powszechnie stosowana w preparatach przeznaczonych do pielęgnacji skóry i ma działanie zapobiegające jej starzeniu się. Posiada również właściwości, które mogą wspierać proces leczenia ran. Witamina A pobudza produkcję włókien kolagenowych oraz zwiększa liczbę fibroblastów, co przyspiesza gojenie ran. Odgrywa również rolę przeciwutleniacza i zmniejsza podatność na zakażenia. Pobudza produkcję czerwonych krwinek i wspomaga zdolność regeneracyjną komórek.
Retinoidy, pochodne witaminy A, przyspieszają gojenie się uszkodzeń naskórka. Mają zastosowanie w leczeniu wielu problemów skórnych, w tym łuszczycy, owrzodzeń, czyraczności czy naskórnych stanów przedrakowych.
Witamina E, dzięki właściwościom antyoksydacyjnym, spowalnia procesy starzenia się komórek. Łatwo przekracza barierę lipidową skóry i poprawia stabilność błony komórkowej. Witamina E posiada też dodatkowe funkcje, m.in. wspiera układ odpornościowy, ma działanie antykoagulacyjne oraz przeciwzakrzepowe.
Witamina C stymuluje szybsze gojenie ran
Naukowcy z Uniwersytetu w Leicester w Wielkiej Brytanii oraz Instytutu Biologii Molekularnej i Komórkowej w Portugalii dowiedli, że witaminę C można wykorzystać w procesie leczenia ran. W publikacji, która ukazała się w czasopiśmie naukowym „Free Radical Biology and Medicine”, udowodniono, że witamina C pobudza spoczynkowe fibroblasty do podziału, co poprawia gojenie się rany. Sprzyja także migracji fibroblastów do uszkodzonego obszaru.
Badania na świniach, na które powołuje się Agnieszka Kantorska w publikacji „Witamina C rola i znaczenie dla organizmu”, wykazały, że doustna suplementacja witaminy C wpłynęła na szybsze gojenie się ran. Jak podkreślono w tej samej publikacji, dzieci z rozległymi oparzeniami, które były suplementowane witaminą C i E, wykazały szybsze gojenie się ran. W innym badaniu zauważono korelację między paleniem tytoniu, który obniża poziom witaminy C, a trudnościami w leczeniu ran. Dodatkowo badania przeprowadzone na populacji azjatyckiej wykazały poprawę formowania blizn po miejscowym zastosowaniu żelu silikonowego z witaminą C.
Wspomaganie procesu gojenia oparzeń
Oparzenie powoduje znaczne straty pierwiastków, w szczególności selenu, miedzi, cynku, żelaza i fosforu, dlatego ważne jest, by uzupełniać ich niedobory.
Miedź utrzymuje prawidłowe funkcje skóry i naczyń krwionośnych. Wpływa też na stan nabłonka, tkanki łącznej, a także bierze udział w produkcji hemoglobiny, mieliny oraz melaniny. Miedź razem z cykiem odpowiada za tworzenie się wiązań poprzecznych w kolagenie i elastynie. Z kolei sam cynk odgrywa dużą rolę w budowie kolagenu, co sprzyja gojeniu się ran. Selen poprawia pracę systemów antyoksydacyjnych, pozytywnie wpływa również na odporność i leczenie ran.
Oparzenia powodują również zwiększone zapotrzebowanie na witaminę D w organizmie, zwłaszcza w procesach metabolicznych, które związane są z utrzymaniem homeostazy wapniowo-fosforanowej oraz z regulacją proliferacji i różnicowaniem komórek. Zwłaszcza przy rozległych oparzeniach z powodu niedoboru witaminy D może dochodzić do dysfunkcji narządów, co powoduje zaburzenia w procesie metabolicznym witaminy D w wątrobie oraz w nerkach. Witamina D w procesie leczenia oparzeń oddziałuje m.in. na procesy związane z rozwojem oraz wzrostem komórek, ma także pozytywny wpływ na formowanie się blizn. Niedobór witaminy D wśród pacjentów z oparzeniami może opóźniać gojenie się rany, przedłużać leczenie i rekonwalescencję.
Przeczytaj także: Doustny TXA skuteczny w zapobieganiu utracie krwi w chirurgii ortopedycznej
Źródła:
Bojarowicz, A. Płowiec, „Wpływ witaminy A na kondycję skóry”, Probl Hig Epidemiol 2010, 91(3): 352-356
H. Saghaleini, K. Dehghan, K. Shadvar i wsp., „Pressure Ulcer and Nutrition”, Indian J Crit Care Med. 2018; 22(4)
Piorun, A. Krajewski, M. Czerwińska-Rogowska i wsp., „Rola miedzi, selenu i cynki w leczeniu oparzeń”, Chirurgia Plastyczna i Oparzenia 2018; 6(2)
A. Kantorska, „Witamina C rola i znaczenie dla organizmu”, Praca poglądowa w ramach specjalizacji z farmacji aptecznej
Jagiellońskie Centrum Innowacji
cordis.europa.eu
M. Markowska, D. Maciejewska, „Suplementacja witaminy D u pacjentów po ciężkich oparzeniach”, Chirurgia Plastyczna i Oparzenia 2016; 4(3)
Właściwa dieta bogata w witaminy i minerały zawsze będzie pomocna czy w budowaniu odporności czy w szybszym zwalczaniu chorób lub regeneracji
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