Dietary Supplementation with Functional Amino Acids Improves Chronic Wound Healing

Conventional nutrition intervention for wound healing includes supplementary protein, calories, vitamins and minerals.  However, dietary supplementation with functional amino acids is more effective. The amino acid, leucine, and its metabolite, beta-hydroxy-beta-methylbutyrate (HMB), activate TOR, a cellular component that switches on cellular protein synthesizing systems. TOR-activated systems are fundamental for building new tissue and healing wounds.

Three cases studies demonstrate how an amino acid-HMB supplement (AA-HMB) improves outcomes.

1. An 84-year-old resident with diabetes and Alzheimer's disease developed multiple pressure ulcers, including one  Stage IV. Initially she received routine wound care, a specialty mattress and conventional dietary supplementation. She was bedridden and had a Foley catheter. Fourteen months later, the ulcers had not healed. The AA-HMB was added b.i.d. Ten weeks later, the Stage IV ulcer was closed and the specialty mattress discontinued and Foley catheter removed  
2. A 78-year-old patient had extended right hemicolectomy for colorectal cancer.  Five days after surgery, the incision had  a sloughy base and moderate exudates. The dressing was switched to one with higher absorbance capacity and higher silver concentration.  At three weeks, the wound was sloughy, granulation tissue was not forming well and there was bleeding and excessive foul-smelling exudate. The dressing was switched to an alginate gel.  One week later, the AA-HMB was added b.i.d.  After two weeks, the wound edges had contracted markedly, granulation improved, exudates lessened and the incision size reduced. After discharge, the patient continued the AA-HMB.  Three weeks later, her wound was completely healed.
3. A 62-year-old with 20-year history of diabetes developed a foot ulcer requiring surgical debridement. He developed osteomyelitis requiring IV antibiotics for the next nine months. Because of the osteomyelitis, poor circulation and  poor ulcer condition, a BKA was recommended.  He added the AA-HMB b.i.d. to his diet. Six weeks later,the wound had closed, the ulcer surface had diminished and the wound care team decided that surgery wasn't required.