Macronutrients, metabolism and burn injury wound healing

Dr Yiwei  Wang1, Dr Jonathan  Hew1, Dr Craig Mooney1, Dr Julian  Smyth1, Miss Roxanne Parungo1, Professor David Le Couteur1, Dr Zhe Li1, Professor Peter  Maitz1

1Anzac Research Institute, Concord West, Australia

Background: Diets high in both protein and energy content have been clinically proven to effectively enhance the wound healing process post severe burn injury. However, the optimum macronutrient composition for small and severe burn injury and the mechanisms by which nutrition influences the healing process remains unclear.

Methods:  Male C57BL6 mice (n = 180) were fed control chow ad libitum for 8 weeks. At 8 weeks, two individual 1x1cm burn injury wounds was surgically created. During the healing process, mice were fed one of 12 experimental diets for 4 weeks. These diets were selected to cover a wide spectrum of macronutrient balance. Wound healing rate was measured and skin/organ biopsy collected on day 3,5,7,10,14, 21 and 28. The metabolic changes were measured using a state of the art “Promethion” metabolic cage system.

Results: We surprisingly found that the optimum diet for small burn injury wound healing is a low protein with an optimal ratio of protein: carbohydrate: fat at P5: C48: F48. Approximate 50% of wounds healed by 4 days compared to the standard chow and the poorest diet (high fat, high protein). In additional to local wound healing, we also found this low protein diet generated better metabolic outcomes over wound repair.

Dr Yiwei Wang is a Senior Research Fellow within the Burns Research Group at the ANZAC Research Institute. Dr Yiwei Wang was awarded her PhD from Kingston University, United Kingdom for development of a new biomaterial-based drug delivery device. She further gained post-doctoral and commercial experience in tissue engineering, drug delivery and wound healing at NPL Management, Ltd, U.K. and the University of Queensland, Australia. She joined the Burns Research Group at the ANZAC Research Institute in 2010 as an expert specializing in wound healing and skin regeneration. She is currently managing the Burns Laboratory and leading several research projects which include investigation of androgens in several burn injuries; development of a living 3D skin substitute and study of the optimal nutritional support in burns wound healing.

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