Nutrition and Metabolism

Obesity, an epidemic condition, develops when the caloric intake obtained from food outweighs the energy need: adipocytes hyperplasia and hypertropia occur in healthy subjects to store the increase amount of fat through lipogenesis. This implies the expansion of adipose tissue (AT) and consequent increase in the amount of body fat. General and abdominal adiposity increases rates and mortality for cardiovascular events, dysmetabolic diseases, and all cancers. Obesity has been associated with skin manifestations and represents a risk factor for poorer surgical outcomes, longer wound healing, post-operative infections, and long-time surgical complications including atelectasis, thrombophlebitis, mortality, and wound separation. Wound healing depends on nutritional status and adequate protein intake and protein stores because a high and permanent proteolytic activity is typical for chronic wounds and proteins are needed at every step of the healing process. Furthermore, carbohydrates and fats are needed to support inflammatory response, cellular activity, angiogenesis, and collagen deposition. Although a large body of evidence indicates that a complementary nutritional approach might be useful in wound treatment, especially for chronic non-healing wounds, the effect of macronutrient supplementation is currently controversial and the question of the type of supplementation remains open, raising the need for further research.