Mixture of Arginine, Glutamine, and ß-hydroxy-ß-methyl Butyrate Enhances the Healing of Ischemic Wounds in Rats.

BACKGROUND: This study investigated the effects of an amino acid mixture containing arginine, glutamine, and ß-hydroxy-ß-methyl butyrate on secondary healing of ischemic wounds in a rat model (N = 18). METHODS: After the formation of a bipediculated flap on each rat, 2 full-thickness excisional skin wounds (2 × 2 cm) were created on every flap. The rats were then randomized into the control and treatment groups. Every rat received standardized rat food throughout the study. The rats in the treatment group were administered an extra 200 mg/kg of L-arginine, 200 mg/kg of L-glutamine, and 40 mg/kg of ß-hydroxy-ß-methyl butyrate per day. Wound sizes were measured on days 0, 4, 10, and 14. The rats were sacrificed, and the wounds were excised for biochemical and histologic examination on the 14th day. RESULTS: As compared with the control group, the treatment group's wound sizes were significantly smaller on days 10 and 14 ( P < .001), as was its inflammatory cell accumulation score ( P = .008). There was no significant difference between the 2 groups in collagen accumulation ( P = .340), granulation tissue maturation ( P = .161), angiogenesis ( P = .387), or reepithelialization ( P = .190) and no significant difference between hydroxyproline concentrations in wounds ( P = .287). DISCUSSION: This amino acid combination seems to have a positive impact on the secondary healing of experimental ischemic wounds when introduced as a supplement to the standard diet, and the reduction in the inflammatory process appears to play a role in this effect.

Traumatic Abdominal Wall Hernia: Early or Delayed Repair?

Traumatic abdominal wall hernia after blunt trauma is a rare entity. They can easily be overlooked in patients who have multiple trauma, as its signs and symptoms may be variable due to the presence of multiple injuries. Imaging with computed tomography or ultrasound confirms the diagnosis as well as identifying any associated injuries. Although surgery is the standard treatment for traumatic abdominal wall hernias, there is no consensus on the early or late repair of the defect. Some authors recommend early surgical intervention in order to avoid the risk of intra-abdominal organ injury, incarceration, and strangulation. In this study, we report our experience in three cases, which did not involve emergency surgery. Long-term outcome is successful. Elective hernia repair may be safe and feasible in stable patients.

Pilot Experimental Study on the Effect of Arginine, Glutamine, and ß-Hydroxy ß-Methylbutyrate on Secondary Wound Healing.

BACKGROUND: Wound healing is a complex process, dependent on available nutrition substrates. When used together with ß-hydroxy ß-methylbutyrate, arginine and glutamine have been shown to increase collagen deposition in human subjects. However, there are no experimental investigations on the influence of this amino acid mixture with regard to secondary wound healing. The aim of this study is to investigate the effects of the supplementation of these 3 amino acids on the healing of open wounds in otherwise healthy animals. MATERIALS AND METHODS: Twelve rats were divided into control and treatment groups. Two 2-cm × 1-cm full-thickness skin defects were prepared on each subject. The rats in both groups received a diet containing 1.2 g of protein per 100 g of body weight per day. The treatment group, in addition, received 200 mg/kg L-arginine, 200 mg/kg L-glutamine, and 40 mg/kg ß-hydroxy ß-methylbutyrate every day. Wound sizes were measured every 2 days. On the 10th day, tissue samples were taken for histopathologic evaluation and also for the measurement of hydroxyproline concentrations. RESULTS: There was no statistically significant difference between mean wound sizes for the 2 groups (P > .05). There was also no statistically significant difference between the groups with regard to histological healing parameters (reepithelialization [P = 1.00], granulation tissue [P = 1.00], collagen accumulation [P = .455], inflammatory cell accumulation [P = .455], angiogenesis [P = .242]) or tissue hydroxyproline concentrations (P = .240). CONCLUSION: Diet supplemented with arginine, glutamine, and ß-hydroxy ß-methylbutyrate is not beneficial in enhancing secondary healing of open wounds in rats. Further research regarding this topic is warranted.