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CONTINUING PROFESSIONAL DEVELOPMENT
THE COMPLEMENTARY APPROACH
1. With regard to wound repair, which
ONE of the following statements is
a) Wound repair can be completed by the
inflammatory response alone.
b) A complex interaction of cellular and
chemical actions initiates temporary
repair by cleaning the wound and
c) Patient health is not an important
consideration in the progress of repair.
d) Pressure sores and other chronic
wounds are bound to occur despite
intensive precautions and treatments to
2. Which ONE of the following statements
is TRUE with regard to vitamin
supplementation in wound repair?
a) Among the vitamins, only ascorbic
acid (vitamin C) is of any benefit since
deficiencies in patients are rare.
b) All oil-soluble vitamins have been
shown to be of proven benefit.
c) While deficiencies in vitamin A are rarely
encountered, nevertheless increased
oral dosage above the RDI may enhance
d) Oral vitamin E is a proven aid to wound
repair as witnessed by consumer support.
3. Which ONE of the following
statements regarding mineral
supplementation is most TRUE?
a) While zinc is one of the least abundant
trace minerals in the body it is still of
prime importance in enzyme-induced
b) High zinc dosages in excess of 100 mg
have little effect on copper metabolism
and are thus safe to use.
c) Zinc is the most important trace mineral
in wound repair and may be best used
as a paste plaster rather than by oral
administration, to reduce potential
d) Of all the important trace minerals,
magnesium and iron have been proven
to be the most effective in wound repair.
4. Which ONE of the following
statements regarding the use of
amino acids in wound repair is most
consistent with current evidence?
a) All amino acids have equal importance
since they constitute the primary
structure of nutritional proteins.
b) Only the basic amino acids lysine, arginine
and glutamine display any benefit.
c) The cysteine-derived compound taurine
is the most important acid in the repair
d) Arginine and glutamine are probably
the most important because of their
multiple essential roles in wound
copper also contribute to collagen
formation, however recommendations
for supplementation are inconclusive
without appropriate CTs.
Finally, it is worth considering the
benefits of certain herbs such as yarrow
and gotu kola in wound healing.
Yarrow, Achillea millefolium, a known
styptic, was also reputed to have been
used by Achilles to heal soldiers’ wounds
after the battle of Troy.
Centella asiatica, appears to strengthen
wounds by stimulating collagen
production, while Aloe vera increases
collagen and cross-linking within
The importance of micronutritional
supplementation should not be
under-valued even though examples
of specific uses may be contentious,
as is stated often in the literature.
Nevertheless, the healing of chronic
wounds and pressure sores in particular
may necessitate careful consideration
of micronutrient deficiencies and their
• The structure of skin is complex, and
requires a concerted series of events
to effect wound repair.
• Wounds result from many different
causes, and may be acute, short
term in repair, or the more difficult
chronic, often requiring an extensive
specialised approach to healing.
• The general health status of the
patient dictates the progress of
wound repair, with age, lifestyle
habits and current medicines being
• While macronutritional agents such
as proteins are important, selected
micronutritional supplements, such
as amino acids, anti-oxidant vitamins
and minerals, may provide some
benefits in healing.
• Identification of micronutritional
deficiencies induced by malnutrition
and the effects of other medicines,
may improve wound repair outcomes.
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