L-arginine improves wound healing after trauma-hemorrhage by increasing collagen synthesis

Academic Article


  • Background: Several studies indicate impaired wound healing after trauma and shock. Wound immune cell dysfunction seems to be responsible for altered wound healing after trauma-hemorrhage (T-H). In this respect, administration of the amino acid L-arginine normalized wound immune cell fraction under those conditions. It remains unknown, however, whether L-arginine improves impaired wound healing after T-H. Methods: To study this, male C3H/HeN mice were subjected to a midline laparotomy (i.e., soft tissue trauma induced), and polyvinyl sponges were implanted subcutaneously at the wound site before hemorrhage (35 ± 5 mm Hg for 90 minutes) or were subjected to sham operation. During resuscitation, mice received 300 mg/kg body weight L-arginine or saline (vehicle). Seven days thereafter, hydroxyproline (OHP), a metabolite of collagen synthesis, was measured in the wound fluid using high-performance liquid chromatography. Collagen types I and III were determined in the wound by Western blot analysis. In addition, wound breaking strength was measured 10 days after T-H or sham operation. Results: The results indicate that OHP was significantly decreased in T-H mice. L-Arginine, however, restored depressed OHP in the wound fluid in the T-H animals. Similarly, L-arginine treatment prevented a significant depression of collagen I synthesis after T-H. Collagen III was not significantly affected by T-H or L-arginine. Most important, L-arginine increased maximal wound breaking strength after severe blood loss. Therefore, L-arginine improves wound healing after T-H by increasing collagen synthesis. Conclusion: Because L-arginine improves wound healing, the results suggest that L-arginine might represent a novel and useful adjunct to fluid resuscitation for decreasing wound complications after trauma and severe blood loss. Copyright © 2005 by Lippincott Williams & Wilkins, Inc.
  • Authors

    Published In

  • Journal of Trauma  Journal
  • Digital Object Identifier (doi)

    Author List

  • Wittmann F; Prix N; Mayr S; Angele P; Wichmann MW; Van Den Engel NK; Hernandez-Richter T; Chaudry IH; Jauch KW; Angele MK
  • Start Page

  • 162
  • End Page

  • 168
  • Volume

  • 59
  • Issue

  • 1