Clinical Corner: Vitamin D & Wound Healing

Happy New Year! Thank you for being a member of the American College of Clinical Wound Care Specialists. We are happy to announce a new section of our new letter that will focus on clinical pearls or quick tips related to wound care. If you have any specific topics or subjects you would like us to focus on feel free to reach out by email.

For the inaugural post and because it is winter here in North Dakota, I want to focus on a topic that we are all deficient in, the correlation between vitamin D levels and hard to heal wounds. Vitamin D deficiency is frequently reported worldwide with a prevalence of around 1 billion people and around 50% of the global population has vitamin D insufficiency, therefore further research is needed to determine its effects on various human organs and systems1.

Studies have shown that vitamin D deficiency can delay wound healing, which may be associated with impaired inflammatory response. One study showed that vitamin D deficiency can have a direct effect on the modulation of cytokine release during inflammation, delaying the epithelial-mesenchymal transition (EMT) process and decrease extracellular matrix (ECM) 2. In patients with diabetes vitamin D supplementation for 12 weeks can have an effect on wound healing. Vitamin D has shown effects on glucose homeostasis, total LDL, ESR, hs-CRP and MDA levels3.

Clinical guidelines suggest checking vitamin D levels in patients that early with a recommended threshold of 50 nmol/L (20 ng/mL)4. Supplementation can be easily prescribed, is inexpensive, and available over the counter. Studies have found the best clinical results from vitamin D supplementation provided daily rather than weekly or monthly because the daily doses produce serum and tissue concentrations5.

In conclusion, vitamin D supplementation has shown effectiveness in wound-healing processes. It is important to teach our patients about eating a balanced diet and supplementing vitamin D when needed.

References

1. Diachkova E, Trifonova D, Morozova E, et al. Vitamin D and its role in oral diseases development. Scoping review. Dent J. 2021;9:1–17. doi: 10.3390/dj9110129

2. Ying Wu, Yiting Gong, Yiming Ma, Qiaofan Zhao, Ruyu Fu, Xiaoming Zhang, Ye Li, Xueyuan Zhi, Effects of vitamin D status on cutaneous wound healing through modulation of EMT and ECM, The Journal of Nutritional Biochemistry, Volume 134,2024,109733, ISSN 0955-2863, https://doi.org/10.1016/j.jnutbio.2024.109733.

3. Reza Razzaghi, Hamideh Pourbagheri, Mansooreh Momen-Heravi, Fereshteh Bahmani, Jafar Shadi, Zahra Soleimani, Zatollah Asemi, The effects of vitamin D supplementation on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double-blind, placebo-controlled trial, Journal of Diabetes and its Complications,

Volume 31, Issue 4, 2017, Pages 766-772, ISSN 1056-8727, https://doi.org/10.1016/j.jdiacomp.2016.06.017.

4. Liu X, Baylin A, Levy PD, Vitamin D deficiency and insufficiency among US adults: prevalence, predictors and clinical implications. Br J Nutr 2018; 119(8):928–936. doi:10.1017/S0007114518000491

5. Khammissa RAG, Ballyram R, Jadwat Y, Fourie J, Lemmer J, Feller L. Vitamin D deficiency as it relates to oral immunity and chronic periodontitis. Int J Dent. 2018;2018:1–9. doi: 10.1155/2018/7315797