ABSTRACT
It has long been recognized that a wound dramatically alters the normal metabolic state and that increased nutrients must be provided to the wound for healing (1–6). Hunter in 1794 (5), followed later by Cuthbertson and Moore (3) in the 1950s, identified the fact that an acute wound takes priority for nutrients in order to heal. As a result, some degree of body protein loss occurs to obtain the necessary amino acids and energy. In general, it was felt that normal healthy man could tolerate some loss of body protein or more specifically lean body mass without complication in order to heal an acute wound. Nutritional support was not emphasized (2–6).
