High Protein Diets and Healing (and Spiders)

It's well accepted that increased protein intake is necessary for wound healing for tissue regeneration and repair.[1] Research studies have shown protein deficiency to contribute to poor healing rates with reduced collagen formation and wound dehiscence (when a wound breaks open along a surgical suture). High exudate (fluids that filter from the circulatory system into a wound or area of inflammation) loss can result in a deficit of as much as 100g of protein in just a single one day. This needs to be replaced with a high protein diet.[2] Protein depletion delays wound healing by prolonging the inflammatory phase and by inhibiting wound remodeling and healing.[3][4] In a study of 108 human patients with wounds, individuals with either low serum protein or serum albumin had significantly weaker wounds than those with higher protein values.[5] Protein deficiencies increase morbidity and mortality in the surgical/trauma patient. Increasing protein intake helps to optimize healing and immune function, and prevent post-surgical complications.[6][7]

What about real world first hand examples? One of my best friends, Curt, recently went on a high protein, low carb diet. The background is, last September he was bit on the shoulder by a Brown Recluse spider, and had no idea when it happened. The wound slowly got larger and, tough SOB that he is, he ignored it for a few weeks before getting it checked out.

If your spider bite looks like this, you might want to have it checked out

Eventually he figured maybe he should have a Doctor look at the growing hole in his body, and he had wound surgery in November, only for the surgery to fail 2 weeks later. It has been a painful and debilitating process for him that's been ongoing over 7 months, but recently he got back into the gym and started dieting full throttle to get back in shape after being laid up for over half a year.

November 10th, 2011; after wound surgery

Here's the story in his own words, along with a bunch of gory photos to drive the point home:

"So after surgery failed and wound treatment started back in December it measured 7.5 cm x 6.5 cm with a depth of 2 cm. 

Thanksgiving day, 2011, in the ER after the surgically sutured wound ripped open again

December 7th, 2011

From there I started the wound vac and wound care three times a week, and measurements were done once a week with no significant changes for well over a month.

After about a month the depth of the wound had healed to around 1.25 cm deep. Now mind you, during the months of November through the end of January I had been eating whatever I wanted (mostly pizza, fried chicken strips and loads of cookies) with the occasional protein shake. 

Just before the skin graft in early January, 2012

Seeing no real results from the wound vac and treatments, my surgeon (aka. Dr. Fuckhead) decided having a skin graph would do the job. January 18th I had the surgery and was told I would rapidly heal. January 23rd, the following Monday, I went in for the first wound care and found out that the skin graph had failed. The surgeon sent me home with no answers as to what to do from there.


Two days later I took it upon myself to check in to a advanced wound care facility. The measurements on January 25th were 7 cm x 6 cm with a depth of around 1 cm. A biopsy was taken and they found that I had a Mersa infection and I was put on the proper antibiotics. Two weeks after taking the antibiotics and having once a week wound care it measured 6 cm x 5 cm with the depth about 0.75 cm, and it continued at the same pace of healing for the next 4 weeks.

February 20th, 2012

At this time I still wasn't dieting but had started to exercise daily. March 9 the wound measured 3 cm x 2 cm with no measurable depth. The following Monday, March 12th, I started a diet of basically nothing but protein shakes. I found I needed a low fat/carb refuel meal every third day to keep my energy up since I had began to go to the gym twice a day. I kept this up for two weeks. The measurements of my wound after those first two weeks of dieting changed dramatically; it measured 1.5 cm x 0.75 cm.

 

March 29th, 2012; a few weeks after starting a high protein, low carb diet

The next week, keeping on my diet slightly modified with more meals with high protein and minimum carbs, the wound measured 0.5 cm x 0.25 cm. This is my fourth week on my diet and my wound has healed down to a small scab almost ready to flake off. I'm amazed how much this high protein diet helped with wound healing. [Jonathan is a genius and my hero!!]"

Ok, so I added in that last little sentence, but here's a first hand demonstration of how a high protein diet affects your body. I think this is fascinating and thought people would benefit from seeing this, and I appreciate Curt letting me post this. This is an extreme and visual demonstration of the effects of increased nitrogen balance through higher protein intake.

Thanks to drastically upping his protein, Curt and this guy have a lot in common now.

References:

1. Douglas MacKay, and Alan L. Miller. Nutritional Support for Wound Healing. Alternative Medicine Review 8.4 (2003): 359-77
2. Russell L. The importance of patients' nutritional status in wound healing. Br J Nurs. 2001 Mar;10(6 Suppl):S42, S44-9. Review. PubMed PMID: 12070399.
3. Ruberg RL. Role of nutrition in wound healing. Surg Clin North Am 1984;64:705-714
4. Haydock DA, Flint MH, Hyde KF, et al. The efficacy of subcutaneous goretex implants in monitoring wound healing response in experimental protein deficiency. Connect Tissue Res 1988;17:159-169.
5. Lindstedt E, Sandblom P. Wound healing in man: tensile strength of healing wounds in some patient groups. Ann Surg 1975;181:842- 846.
6. Correia M, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 2003;22:235-239.
7. Himes D. Protein-calorie malnutrition and involuntary weight loss: the role of aggressive nutritional intervention in wound healing. Ostomy Wound Manage 1999;45:46-51, 54-55.