Aim: To review available literature on the role of Arginine supplementation in wound healing.
Methods: Data sources: Peer-reviewed literature from PubMed, Scopus, Web of Science, MEDLINE, Cochrane Library, EMBASE, CINAHL,CAM on PUBMED, ProQuest, ScienceDirect and Informit library were searched using “Arginine”, “ulcer”, “wound healing” as key words. Study selection and Data extraction: Journal Articles were critically appraised by independent reviewers using the Critical Appraisal Skills Programme (CASP). Data extraction was conducted using data on study design, methodology, dosage, mode of administration, and clinical outcomes. Main Outcome measures: The effect of various modes of Arginine supplementation on wound healing with/without other nutrients.
Results: 4184 articles were reviewed: 16 studies met the inclusion criteria. Ten studies examined the role of L-Arginine supplementation in Pressure Ulcers, while four studies assessed its effects in Diabetic Foot Ulcers and other studies investigated the healing effects of L-Arginine in wound healing scenarios including skin graft sites and cancer. Shorter healing times and reduced ulcer size were the most commonly reported favourable outcomes when comparing supplementation with Arginine to controls in wound healing.
Conclusion: Unlike Arginine supplementation in Pressure Ulcers, there are very few published randomized control trials of supplementation of Arginine in Diabetic Foot Ulcers. There is evidence that Arginine supplementation reduces the time to healing of various ulcers, including Diabetic Foot Ulcers. Arginine supplementation is a simple complimentary medical nutrition therapy that may be useful for Diabetes Educators and Dietitians in the treatment of Diabetic Foot Ulcers in addition to standard therapy to reduce the size of diabetic ulcers and healing times. However, further evidence is required, particularly larger randomized control trials, before Arginine can be added to the toolkit of Diabetes Educators treating diabetic ulcers.
The first 3 authors are recipients of an ADEA grant for work in L-Arginine and Diabetic Foot Ulcers
This work was supported by a Townsville Hospital & Health Services Allied Health Research Grant