Saying Goodbye to Surgery Scars

If you’re planning to have cancer surgery in the near future or recently had surgery, your thoughts undoubtedly move to how you can minimize the trauma and scarring associated with treatment and speed the healing process. Healing wounds whether from accidental injury or surgical intervention requires a delicate interplay of multiple cell types, nutritional factors, immune processes and growth factors. Proper planning and prompt attention can promote normalization in appearance.

Healing -From the Inside Out
Wound healing is a stepwise process involving hemostasis, inflammation, and remodeling. During hemostasis, blood platelets release clotting factors and growth factors to help the body create a protective wound scab. This barrier provides a surface beneath which cell movement can occur. Then the process of inflammation brings nutrients to the area, removes debris and bacteria, and provides chemical signals for wound repair. Healing proceeds only after inflammation is controlled. The repair process can then begin to build new skin, fibrous tissue and blood vessels.

Deficiencies of proteins, vitamins, minerals and fluids may significantly impair the healing process. Vitamin C (ascorbic acid) found in citrus fruits, tomatoes, green peppers is required for the formation of the connective tissue protein collagen. The precursor to Vitamin A (retinol) is found in carrots, cantaloupe, tomatoes, eggs, butter and cheese. It is essential for cell growth, skin and bone formation and immunity. The body uses glucosamine to build connective tissue. Adequate dietary protein is necessary to build new tissue. Surgical trauma produces a sharp decrease in serum zinc concentration. Zinc is an important cofactor for enzymes that control the collagen matrix. It has demonstrated anti-infective action, inhibits formation of reactive oxygen species and promotes skin formation.

Healing- From the Outside In
Topical vitamin E and ascorbic acid, calcium D-pantothenate and fibronectin can speed wound healing. Other novel approaches involve topical application of a mixture of various growth factors (PDGF, TGF-beta, PDAF, PF4, PDEGF) to slow healing wounds although the marketplace has only supported the use of platelet derived growth factor (PDGF-BB). Skin graft donor site healing time has been reduced by 1 day using topically applied epidermal growth factor (EGF). (Komarcevic) Zinc oxide in paste bandages (Unna boot) protects and soothes inflamed skin. Topical administration of zinc appears to be superior to oral therapy due to its action in reducing superinfections and enhancing local defense systems.

Pressure is thought to decrease tissue metabolism and increase collagen breakdown within the wound. Silicon gel sheets (applied for 12 hours/day) add pressure and are also thought to work by hydrating the scar tissue. Rehydration softens the scar, thereby making it more flexible and improving the natural repair and flattening process. The newer the scar, the better the result. Onion extract (Mederma) has shown improvement for hypertrophic and keloids scars. However, it was ineffective in improving scar height and itching. For this reason, onion extract therapy should be used in combination with an occlusive silicon dressing to achieve a desirable decrease in scar height. Aquaphor is a petroleum based product that has been shown to speed healing of damaged skin.

In summary, each phase of tissue repair can be influenced by nutritional, biological, botanical factors and mechanical approaches.

 

Stage	Nutritional/ Botanical Factors	Physical/Mechanical Factors
Hemostasis*	Topical zinc paste ( anti-microbial)	Topical hyaluronic acid Aloe Vera Aquaphor Silicone Sheets
Inflammation	Omega-3 fatty acids Protein Vitamins C/A Glucosamine Bromelain
Proliferation	Vitamin C Glucosamine Zinc Centella asiatia (collagen formation)
Remodeling	Protein  i.e. arginine enhanced diet, hydrolyzed collagen supplement

*Avoid factors that inhibit blood clotting prior to surgery

Cancer is a significant factor in slowing wound repair. Processes intrinsic to cancer, such as hormonal disregulation, chronic inflammation, nutritional deficits, etc. work against the repair process. However, addressing these clinical issues and integrating the above approaches can improve the wound repair process.

References

Brown, SA. Plast Reconstr Surg. 2004 Jul;114(1):237-44 Oral nutritional supplementation accelerates skin wound healing: a randomized, placebo-controlled, double-arm, crossover study.

Chithra, P. Mol Cell Biochem. 1998 Apr;181(1-2):71-6. Influence of Aloe vera on collagen characteristics in healing dermal wounds in rats.

Chung, V. Dermatol Surg. 2006 Feb;32(2):193-7 Onion extract gel versus petrolatum emollient on new surgical scars: prospective double-blinded study.

Diegelmann, R. Front Biosci. 2004 Jan 1;9:283-9. Wound healing: an overview of acute, fibrotic and delayed healing.

Hosnuter, M. J. Wound Care. 2007 Jun;16(6):251-4. The effects of onion extract on hypertrophic and keloid scars.

Komarcevic , A. Med Pregl. 2000 Jul-Aug;53(7-8):363-8. The modern approach to wound treatment.

Lansdown, A. Wound Repair Regen. 2007 Jan-Feb;15(1):2-16. Zinc in wound healing: theoretical, experimental, and clinical aspects.

MacKay, D. Altern Med Rev. 2003 Nov;8(4):359-77 Nutritional support for wound healing.

Mandal, A. J Wound Care. 2006 Jun;15(6):254-7. Do malnutrition and nutritional supplementation have an effect on the wound healing process?

McCarty, M. Med Hypotheses. 1996 Oct;47(4):273-5. Glucosamine for wound healing.
Russell, L. Br J Nurs. 2001 Mar;10(6 Suppl):S42, S44-9. The importance of patients’ nutritional status in wound healing

Phillips, S. ASAIO J. 2000 Nov-Dec;46(6):S2-5. Physiology of wound healing and surgical wound care.

To find these products, please visit www.DrDonnaDouglas.com/shop.html   Enter code “drdoug”

Inflammenz
Emerson Ecologics Advanced Formula Enzymes

Product Code: INFL9

Glucosamine
Emerson Ecologics Pure Encapsulations

Product Code: GLU70

Protein

Emerson Ecologics Designs for health

Product Code: WHEY6

The milk harvested for this product comes from cows that graze on pesticide and chemical-free natural grass pastures. Milk from grass-fed cows has many times higher levels of CLA and contains a proper balance of essential fatty acids. The milking cows are never fed grain or subjected to any growth hormone treatment, chemicals, antibiotics, genetically modified organisms, hyperimmunization or injected pathogens.

This whey protein is produced using a unique low temperature drying and filtration method. The vast majority of whey proteins available use high heat pasteurization. High heat does irreversible damage to the majority of the components of milk and may cause intolerance even in individuals who have no history of milk allergies.

Silicone Gel sheets

Breast surgery Pre-shaped silicone sheets
http://www.rejuveness.com/Breast-Scar-Treatment-c8.html?REJUVE=7rk3e5b45c609hgtis1orncgd4

http://www.makemeheal.com/mmh/product.do?id=13189

http://www.allegromedical.com/wound-care-c541/cica-care-silicone-gel-sheeting-p177443.html

http://www.plasticsurgery.org/medical_professionals/health_policy/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=23500

Other wound care products
http://www.southwestmedical.com/Woundcare_Products/Specialty_Woundcare/CollagenSilicone/574c0

http://www.medscape.com/viewarticle/418377_2 adding EGF to wounds to speed healing

http://findarticles.com/p/articles/mi_m0FDN/is_4_8/ai_111303980/pg_4 (awesome, in depth)

Five Ways to Fight the Swine Flu

View the Swine Flu video here.

 

Winter in North America brings with it yearly uninvited guests- flu bugs- multiple strains of illness causing viruses just waiting for new bodies to infect.   The most common recommendation has been to protect yourself with a flu vaccine.  But with virtually all the US flu suddenly resistant to the leading antiviral Tamiflu, health officials are worried about where this could lead.  Here are some key guidelines you MUST know if you want to survive this year’s flu season.

 

How can you distinguish a cold from the flu? First understand that colds are minor infections of the nose and throat which usually develop slowly as a scratchy, sore throat, followed by sneezing and a runny nose.  The flu, however, affects the entire body and symptoms appear suddenly, quite often as headache, muscle aches and fever.  (See comparison chart)

 

Symptoms                Cold              Flu

fever                   rare                characteristic, high (102-104F);

                                              lasts 3-4 days

headache                rare               prominent

general aches,pains     slight              usual; often severe

fatigue,weakness        quite mild         can last up to 2-3 weeks

extreme exhaustion      never               early and prominent

stuffy nose             common              sometimes

sneezing                usual              sometimes

sore throat             common              sometimes

chest discomfort,       mild to moderate   common;can become severe cough

                        hacking cough

FDA Consumer Magazine (October 1996)

 

Get to your physician immediately if there is  trouble breathing, fast breathing or wheezing ; bluish skin color; earache or drainage from the ear; changes in mental state (such as not waking up, irritability or seizures) .

Colds are caused by viruses and there are over 200 of them.  This variety has made it difficult for scientists to develop an effective control.  Antibiotics are not useful and should only be taken to treat bacterial complications which can arise.  Influenza (commonly called “the flu”)   is an illness caused by a small set of viruses- the influenza viruses types A, B and C.  Type A is responsible for the most common, more virulent attacks.

 

So what are your options?

 

Conventional treatment options in combination with select botanicals used for thousands of years in traditional Eastern medicine may help in the treatment and prevention of the flu.    

 

• Maintain adequate humidity levels in your environment.  Winter air is arid, drying the lining of the nasal passages, making them more susceptible to infection.  Many humidifiers now have a special receptacle for inhalants.  Inhalants are essential oils suspended in a petroleum jelly or other matrix (such as Vicks Vaporub). Oils of Eucalyptus citriodora, Eucalyptus globulus, Mentha piperita, Origanum syriacum, Salvia fruticosa and Rosmarinus officinalis have direct activity on the respiratory tract, the coughing reflex and the airflow in the nasal tract.  When making your own remember that more doesn’t necessarily mean better.  Researchers found that 0.2% concentrations of essential oils result in stronger effects when compared with 2% concentrations.

 

• Over the counter medicines help relieve flu symptoms but do not fight the virus.  Analgesics such as Motrin (ibuprofen) and Tylenol (acetaminophen)  relieve pain.     Sinupret, a product used successfully in Europe for over 70 years, shows  effectiveness similar to other mucoactive agents without their side effects.  Sinupret is now available in the United States and can be used in children. Decongestants which work to reduce the swelling of blood vessels in the nasal cavity are not recommended for patients with heart disease, hypertension, thyroid disease, diabetes, or, in men with an enlarged prostate.  Their danger and questionable effectiveness is highlighted by the FDA’s recommended ban on children’s decongestants.  Nasal washes (SinuCleanse or Netipot) can also be used to flush out mucus that has built up in the nasal passages.

 

 

• Prescription drugs for the flu have been on the market since 1976 when the FDA approved Symmetrel (amantadine).  It later approved Flumadine (rimantadine) and more recently Relenza and Tamiflu. The complication is that they work only if administered within the first 48hrs after symptoms appear.  However, a number of botanicals demonstrate antiviral activity.  Standardized Olive Leaf extract and Black Elderberry extract (Sambucus/ Sambucol) demonstrate antiviral activity and offer excellent coverage when used in combination.   They are typically used every 4 hrs for 5 – 7 days.

 

• Acetylcysteine and carbocysteine, 2 naturally derived products,  are the most commonly prescribed mucolytics in many European countries.  Clinically effective dose is 1200 mg oral N-acetylcysteine per day. (Ghanei, M.)  Emerging evidence suggests high lactoferrin whey protein inhibits viral functioning but further studies are needed.

 

• Additionally, drink plenty of fluids- water is best.  Get your rest, keep taking your multivitamins and you’ll be well on your road to recovery.

 

 

 

 

Cytotechnology. 2003 Nov;43(1-3):145-8.  Effects of carvacrol on sister chromatid exchanges in human lymphocyte cultures

 

Curr Pharm Des. 2008;14(29):3106-19. Biological and pharmacological activities of carvacrol and carvacrol bearing essential oils

 

Altern Med Rev. 2007 Mar;12(1):25-48.  Colds and influenza: a review of diagnosis and conventional, botanical, and nutritional considerations

 

Biochem Biophys Res Commun. 2007 Mar 23;354(4):872-8. Discovery of small-molecule HIV-1 fusion and integrase inhibitors oleuropein and hydroxytyrosol: Part I. fusion [corrected] inhibition.

 

Antiviral Res. 2005 Jun;66(2-3):129-36.  The olive leaf extract exhibits antiviral activity against viral haemorrhagic septicaemia rhabdovirus (VHSV).

 

J Ethnopharmacol. 2005 Apr 26;98(3):323-7. Antiviral activity in vitro of Urtica dioica L., Parietaria diffusa M. et K. and Sambucus nigra L.

 

Zhongguo Zhong Yao Za Zhi. 2004 Feb;29(2):109-11. Advances in research on chemistry and pharmacology of Sambucus chinensis.

 

J Int Med Res. 2004 Mar-Apr;32(2):132-40. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections.

 

Harefuah. 2008 Oct;147(10):783-8, 838. The treatment of respiratory ailments with essential oils of some aromatic medicinal plants

 

Eur Cytokine Netw. 2001 Apr-Jun;12(2):290-6. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. 

 

J Ethnopharmacol. 1995 Dec 1;49(2):101-10. Antiviral screening of British Columbian medicinal plants.

 

Am J Rhinol. 2008 Mar-Apr;22(2):130-4 . Influence of essential and fatty oils on ciliary beat frequency of human nasal epithelial cells.

 

Forsch Komplementmed. 2006 Apr;13(2):78-87.  Systematic review of clinical data with BNO-101 (Sinupret) in the treatment of sinusitis.

 

Cochrane Database Syst Rev. 2009 Jan 21;(1):CD003124. Acetylcysteine and carbocysteine for acute upper and lower respiratory tract infections in paediatric patients without chronic broncho-pulmonary disease.

 

Basic Clin Pharmacol Toxicol. 2008 Nov;103(5):428-32. N-acetylcysteine improves the clinical conditions of mustard gas-exposed patients with normal pulmonary function test.

 

FEBS Journal, Volume 239, Number 1, July 1996 , pp. 156-164(9). Interaction of the Lantibiotic Nisin with Membranes Revealed by Fluorescence Quenching of an Introduced Tryptophan.

 

Med Microbiol Immunol. 2009 Feb;198(1):19-25.  Inhibition of HBV infection by bovine lactoferrin and iron-, zinc-saturated lactoferrin. 

 

J Nutr. 2008 Dec;138(12):2392-8.  Supplementing suckling rats with whey protein concentrate modulates the immune response and ameliorates rat rotavirus-induced diarrhea. 

Welcome!

Welcome to Dr. Donna’s Health in a Minute . Here you’ll find a positive spin on the latest news you can use to build the best you possible.  Let me know your thoughts!