Intravenous arginine and human skin graft donor site healing: a randomized controlled trial.

Author(s): Debats IB, Koeneman MM, Booi DI, Bekers O, van der Hulst RR

Affiliation(s): Department of Plastic, Reconstructive and Hand Surgery, University Hospital Maastricht, 6202 AZ Maastricht, The Netherlands. ibjgdebats@gmail.com

Publication date & source: 2011-05, Burns., 37(3):420-6. Epub 2010 Nov 18.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

BACKGROUND AND AIMS: Studies evaluating the effect of arginine supplementation in human wound healing are inhomogeneous with conflicting results. This study aims to clarify the role of arginine supplementation in the healing of human skin graft donor sites. METHODS: 35 subjects undergoing skin autografting were randomly assigned to receive intravenous arginine (n = 16) or placebo (n = 19) for 5 days in a dose of 30 g of arginine or an isovolumetric amount of placebo (25.2g of alanine). Wound healing was evaluated at the donor sites by objectifying angiogenesis, reepithelialization and neutrophil influx. Plasma amino acid concentrations were measured to evaluate our intervention. RESULTS: The two groups were comparable in age, morbidity and nutritional, metabolic and inflammatory state. Plasma arginine and alanine levels increased significantly upon supplementation in the two groups, respectively. No differences were found between the arginine supplementation group and the placebo group in the studied parameters. Placebo vs. arginine; mean +/- SD: neutrophil influx on day 2: 6.67 +/- 3.0 vs. 6.57 +/- 3.3, p = 0.66; angiogenesis on day 10: 8.0 +/- 2.8 vs. 8.9 +/- 3.1; reepithelialization in % on day 10: 81 +/- 8.5 vs. 85 +/- 7.1. CONCLUSION: Intravenous arginine supplementation does not improve angiogenesis, reepithelialization or neutrophil influx in healing of human skin graft donor sites. Copyright (c) 2010 Elsevier Ltd and ISBI. All rights reserved.