ABSTRACT

Quantitative Estimate of Collagen Turnover as an Indicator of the Dynamic Metabolic Process of Wound Healing.............................. 50 Experimental Models for Assessing the Dynamics of Skin DNA and Protein Metabolism .............................................................................. 51

DNA Metabolism .................................................................................................... 52 Determination of Protein Synthesis and Degradation Rates in the Epidermis and Dermis............................................................................................. 53

Physiological Regulation of Wound Metabolism and Wound Healing Process in Relation to Whole Body Metabolic State ................................. 54

Effect of Low-Protein Diet on the Wound.............................................................. 56 Effect of High-Protein Diet on the Wound............................................................. 56 Importance of Specific Amino Acids...................................................................... 56 Recommendations for Protein Intake to Optimize Wound Repair......................... 57 Future Directions in Clinical Nutritional Support in Relation to Wound Healing ........................................................................................................ 58 Toxicity of Protein Excess ...................................................................................... 59 References................................................................................................................ 61

Wound healing is a dynamic, interactive process involving soluble mediators, blood cells, extracellular matrix, and parenchymal cells. The healing process of the wound can be divided into three phases — inflammation, tissue formation, and tissue remodeling — that overlap in time. Many aspects of the detailed mechanisms of this pathophysiological processes, and hence, the approaches to modulate the healing process, are still under extensive investigation. However, this complicated healing process, including the various morphological changes, can also be viewed as a complicated metabolic process (i.e., the utilization of various substrates by the cells in the area of injury for the recovery of their normal lives and functions, including the protein synthesis and degradation in the repairing of the wound and the renewal of tissues). All these regional metabolic processes are also associated with the whole

body metabolic status of the host under the conditions of health and severe trauma, such as thermal injury.