by Paula Simpson, B.Sc., RNCP
Whereas good nutrition facilitates healing, undernourishment delays, inhibits and complicates the process. In order to reduce recovery time and improve results, a patient’s health and nutritional status prior to surgery is a critical factor in the treatment paradigm. Furthermore, as a growing number of consumers seek cosmetic enhancement procedures with minimal recovery time, complementary protocols such as nutraceuticals are attractive to support their surgical outcome and healing process.
Cosmetic or not, any surgical procedure has a profound effect on metabolic needs, the immune response, oxidative stress on the body and the inflammatory regulatory pathways. Although under most circumstances the systemic inflammatory response is beneficial in improving the eventual outcome of the surgical area, excessive pro-inflammation or excessive counter inflammation can worsen healing time and outcome. Nutritional therapeutic strategies directed at restoring immune homeostasis should aim to redress the physiological pro-inflammatory/anti-inflammatory cell imbalance associated with major surgery and provide critical nutrients to promote optimal skin re-epithelisation and rejuvenation.
Post-Surgery Nutraceuticals
The issue of supplementation in aiding wound healing is debatable. However, promising clinical data has shown certain nutraceuticals may assist in improving the rate of recovery by strengthening the immune system, minimizing inflammation and supporting all phases of dermal repair. This is not surprising as the skin is the protective barrier against external insults and any lesion must be rapidly and efficiently repaired. Dermal fibroblasts are the major source of extracellular connective tissue matrix and play an important role in wound healing. Vitamin C, for example, is a potent water-soluble free radical scavenger and an essential cofactor for collagen synthesis by the dermal fibroblasts.
Even with a balanced diet, certain nutraceuticals may improve the treatment process, minimize nutrient deficiencies and post-surgical side effects. To date, some of the leading ingredients shown in clinical studies to support dermal healing include:
Protein—Protein depletion can affect the rate and quality of wound healing (Gray and Cooper 2001). There is an increase in demand for protein in the presence of a wound, a requirement further increased in the event of sepsis or stress. Protein is required as part of the inflammatory process, in the immune response and in the development of granulation tissue. The main protein synthesised during the healing process is collagen, and the strength of the collagen determines wound strength.
Arginine—The amino acid arginine becomes essential during severe stress. It is abundant in the structure of collagen and increases its tensile strength.
L-Glutamine—L-glutamine is the most abundant amino acid but in times of healing is required for net as a source of energy and proliferation of the fibroblasts, stimulates immunity and works as a buffering agent to reduce acidosis.
Super Oxide Dismutase (SOD)—This antioxidant enzyme has a distinct advantage over the antioxidants consumed from the diet or nutritional supplements, like the vitamins A, C and E since it works as a biological catalyst rapidly and repeatedly reducing reactive oxygen species without being consumed itself. For example, GLISODIN® SOD extracted from cantaloupe melon has been shown in more than 20 clinical studies to offer therapeutic means for the prevention and treatment of many conditions associated with increased oxidative stress and inflammation.
French Maritime Pine Bark—An extract of pine bark has been proven for its anti inflammatory and antioxidant properties. It has also been shown to increase intracellular synthesis of antioxidative enzymes and by acting as a potent scavenger of free radicals (all critical for a healthy dermal healing.)
Gotu Kola Seed (Centella asiatica)—Traditionally used in India, China and Indonesia to treat wounds and skin conditions such as psoriasis, this unique plant stimulates collagen and glycosaminoglycan synthesis, of the wound while improving tensile strength. It has also been shown to increases wound levels of antioxidants (SOD, catalase, glutathione peroxidase).
Zinc & Copper—Both are important cofactors in enzymatic reactions, and are required for the cross-linking of collagen and elastin. There is an increased demand for zinc during cell proliferation and protein secretion. Zinc also has an inhibitory effect on bacterial growth and is involved in the immune response.
Vitamin C—It plays an important role in collagen synthesis and in the formation of bonds between strands of collagen fibre (helping to provide extra strength and stability).
Pre- & Probiotics—The human body requires beneficial bacteria to support an array of functions, including digestive function and healthy immunity. Probiotics are healthy organisms that can be provided through food and/or supplementation for these benefits. Prebiotics are derived from insoluble fiber and fructooligosaccharides (the sugars often found in fruits and honey); prebioitics selectively stimulate growth and/or activity upon contact with intestinal microflora (feeding a healthy microflora). Studies show they both benefit in enhancing nutrient absorption, especially calcium, inhibiting pathogen overgrowth, enhancing immune function, promoting regularity, which are all critical factors for the healing process.
Bromelain—A class of protease enzymes derived from the stem and fruit of the pineapple family. The National Institute of Health (NIH) supported there is good scientific evidence bromelain is an effective treatment for inflammation, pain associated with inflammation.
Arnica (Arnica montana)—A bitter and astringent herb has been used in Eastern medicine for some time and more so now in North America. Arnica is often used topically post surgically, but can also be taken orally and is well-known for its anti-inflammatory and antibiotic properties.
These nutraceuticals can help prepare the body for cosmetic surgery, and can create a strong immune environment that help the inflammatory process, recovery time and wound healing.
Paula Simpson has 15 years of experience in consulting, public relations, product formulation and program development for the nutraceutical and weight-loss industry. Her role as a scientific evaluator and regulatory consultant for some of the top nutraceutical companies has solidified her reputation as a leader in R&D for natural health products. As the program director for a medical spa, she developed a weight-loss and anti-aging program. She is the co-founder and one of the formulators behind the GliSODin Skin Nutrients nutricosmetic line. She is also a contributing editor to many medical aesthetic and beauty publications in North America.