Skip to main content
SpringerLink
Log in

Nutrition and Metabolism

  • Chapter
  • First Online:
Pearls and Pitfalls in Skin Ulcer Management

  • 198 Accesses

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. World Health Organization. Obesity and overweight. World Health Organization. 2018. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Last seen 31 Dec 2020.

  2. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). J Am Med Assoc. 2001;285(19):2486–97.

    Article  Google Scholar 

  3. Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome—a new world-wide definition. A consensus statement from the International Diabetes Federation. Diabet Med. 2006;23(5):469–80.

    Article  CAS  PubMed  Google Scholar 

  4. Pischon T, Boeing H, Hoffmann K, Bergmann M, Schulze MB, Overvad K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008;359(20):2105–20.

    Article  CAS  PubMed  Google Scholar 

  5. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. Adults. N Engl J Med. 2003;348(17):1625–38.

    Article  PubMed  Google Scholar 

  6. Crudele L, Piccinin E, Moschetta A. Visceral adiposity and cancer: role in pathogenesis and prognosis. Nutrients. 2021;13(6):2101.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Bays H, Abate N, Chandalia M. Adiposopathy: sick fat causes high blood sugar, high blood pressure and dyslipidemia. Futur Cardiol. 2005;1(1):39–59.

    Article  CAS  Google Scholar 

  8. Stefanadi EC, Dimitrakakis G, Antoniou CK, Challoumas D, Punjabi N, Dimitrakaki IA, et al. Metabolic syndrome and the skin: a more than superficial association. Reviewing the association between skin diseases and metabolic syndrome and a clinical decision algorithm for high risk patients. Diabetol Metab Syndr. 2018;10(1):9.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Hu Y, Zhu Y, Lian N, Chen M, Bartke A, Yuan R. Metabolic syndrome and skin diseases. Front Endocrinol. 2019;10:788.

    Article  Google Scholar 

  10. Crujeiras AB, Carreira MC, Cabia B, Andrade S, Amil M, Casanueva FF. Leptin resistance in obesity: an epigenetic landscape. Life Sci. 2015;140:57–63.

    Article  CAS  PubMed  Google Scholar 

  11. Rosen J, Darwin E, Tuchayi SM, Garibyan L, Yosipovitch G. Skin changes and manifestations associated with the treatment of obesity. J Am Acad Dermatol. 2019;81(5):1059–69.

    Article  PubMed  Google Scholar 

  12. Hirt PA, Castillo DE, Yosipovitch G, Keri JE. Skin changes in the obese patient. J Am Acad Dermatol. 2019;81(5):1037–57.

    Article  PubMed  Google Scholar 

  13. Pierpont YN, Dinh TP, Salas RE, Johnson EL, Wright TG, Robson MC, et al. Obesity and surgical wound healing: a current review. ISRN Obes. 2014;2014:1–13.

    Article  Google Scholar 

  14. Barber GA, Weller CD, Gibson SJ. Effects and associations of nutrition in patients with venous leg ulcers: a systematic review. J Adv Nurs. 2018;74(4):774–87.

    Article  PubMed  Google Scholar 

  15. Danielsson G, Eklof B, Grandinetti A, L. Kistner R. The influence of obesity on chronic venous disease. Vasc Endovasc Surg. 2002;36(4):271–6.

    Article  Google Scholar 

  16. Drake DJ, Swanson M, Baker G, Pokorny M, Rose MA, Clark-Reed L, et al. The association of BMI and Braden total score on the occurrence of pressure ulcers. J Wound Ostomy Continence Nurs. 2010;37(4):367–71.

    Article  PubMed  Google Scholar 

  17. Huynh P, Phie J, Krishna SM, Golledge J. Systematic review and meta-analysis of mouse models of diabetes-associated ulcers. BMJ Open Diabetes Res Care. 2020;8(1):e000982.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Goodson WH, Hunt TK. Wound collagen accumulation in obese hyperglycemic mice. Diabetes. 1986;35(4):491–5.

    Article  CAS  PubMed  Google Scholar 

  19. Dopytalska K, Baranowska-Bik A, Roszkiewicz M, Bik W, Walecka I. The role of leptin in selected skin diseases. Lipids Health Dis. 2020;19(1):215.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Takahashi H, Tsuji H, Takahashi I, Hashimoto Y, Ishida-Yamamoto A, Iizuka H. Plasma adiponectin and leptin levels in Japanese patients with psoriasis. Br J Dermatol. 2008;159(5):1207–8. https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2133.2008.08823.x.

    CAS  PubMed  Google Scholar 

  21. Tadokoro S, Ide S, Tokuyama R, Umeki H, Tatehara S, Kataoka S, et al. Leptin promotes wound healing in the skin. PLoS One. 2015;10(3):e0121242.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Takahashi H, Honma M, Ishida-Yamamoto A, Iizuka H. Adiponectin and leptin modulate cell proliferation and cytokine secretion of normal human keratinocytes and T lymphocytes. J Dermatol Sci. 2010;59(2):143–5.

    Article  CAS  PubMed  Google Scholar 

  23. Frank S, Stallmeyer B, Kämpfer H, Kolb N, Pfeilschifter J. Leptin enhances wound re-epithelialization and constitutes a direct function of leptin in skin repair. J Clin Invest. 2000;106(4):501–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Rosa DF, Sarandy MM, Novaes RD, Freitas MB, do Carmo Gouveia Pelúzio M, Gonçalves RV. High-fat diet and alcohol intake promotes inflammation and impairs skin wound healing in Wistar rats. Mediators Inflamm. 2018;2018:1–12.

    Article  Google Scholar 

  25. Kalan L, Loesche M, Hodkinson BP, Heilmann K, Ruthel G, Gardner SE, et al. Redefining the chronic-wound microbiome: fungal communities are prevalent, dynamic, and associated with delayed healing. mBio. 2016;7(5):e01058-16. https://journals.asm.org/doi/10.1128/mBio.01058-16

    Article  PubMed  PubMed Central  Google Scholar 

  26. Rood KM, Buhimschi IA, Jurcisek JA, Summerfield TL, Zhao G, Ackerman WE, et al. Skin microbiota in obese women at risk for surgical site infection after cesarean delivery. Sci Rep. 2018;8(1):8756.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Wild T, Rahbarnia A, Kellner M, Sobotka L, Eberlein T. Basics in nutrition and wound healing. Nutrition. 2010;26(9):862–6.

    Article  PubMed  Google Scholar 

  28. Collins N. Obesity and wound healing. Adv Skin Wound Care. 2003;16(1):45–7.

    Article  PubMed  Google Scholar 

  29. McGuire S, World Health Organization. Comprehensive implementation plan on maternal, infant, and young child nutrition. Geneva, Switzerland, 2014. Adv Nutr. 2015;6(1):134–5.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Stechmiller JK. Understanding the role of nutrition and wound healing. Nutr Clin Pract. 2010;25(1):61–8.

    Article  PubMed  Google Scholar 

  31. Roth GS, Kowatch MA, Hengemihle J, Ingram DK, Spangler EL, Johnson LK, et al. Effect of age and caloric restriction on cutaneous wound closure in rats and monkeys. J Gerontol A Biol Sci Med Sci. 1997;52(2):B98–102.

    Article  CAS  PubMed  Google Scholar 

  32. Choi YJ. Shedding light on the effects of calorie restriction and its mimetics on skin biology. Nutrients. 2020;12(5):1529.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Hayati F, Maleki M, Pourmohammad M, Sardari K, Mohri M, Afkhami A. Influence of short-term, repeated fasting on the skin wound healing of female mice. Wounds. 2011;23(2):38–43.

    PubMed  Google Scholar 

  34. Csiszar A, Sosnowska D, Tucsek Z, Gautam T, Toth P, Losonczy G, et al. Circulating factors induced by caloric restriction in the nonhuman primate Macaca mulatta activate angiogenic processes in endothelial cells. J Gerontol A Biol Sci Med Sci. 2013;68(3):235–49.

    Article  CAS  PubMed  Google Scholar 

  35. Reed MJ, Penn PE, Li Y, Birnbaum R, Vernon RB, Johnson TS, et al. Enhanced cell proliferation and biosynthesis mediate improved wound repair in refed, caloric-restricted mice. Mech Ageing Dev. 1996;89(1):21–43.

    Article  CAS  PubMed  Google Scholar 

  36. Barchitta M, Maugeri A, Favara G, Magnano San Lio R, Evola G, Agodi A, et al. Nutrition and wound healing: an overview focusing on the beneficial effects of curcumin. Int J Mol Sci. 2019;20(5):1119.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

The authors acknowledge Smart Servier Medical Art (http://smart.servier.com/—accessed date: 17 June 2022) for providing comprehensive medical and biological figures and datasets of interest for the international scientific community.

Author information

Authors and Affiliations

  1. Università degli Studi di Bari Aldo Moro (Bari), Bari, Italy

    Lucilla Crudele, Marica Cariello & Antonio Moschetta

Authors
  1. Lucilla Crudele
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marica Cariello
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Antonio Moschetta
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Antonio Moschetta .

Editor information

Editors and Affiliations

  1. Unit of Plastic and Reconstructive Surgery, Department of Precision and Regenerative Medicine and Jonic Area, University of Bari, Bari, Italy

    Michele Maruccia

  2. Plastic Surgery Unit, University of Trieste, Cattinara Hospital, Trieste, Italy

    Giovanni Papa

  3. Difficult Wound Healing Unit, Policlinico di Monza, Vercelli, Italy, Italy

    Elia Ricci

  4. Plastic and Reconstructive Surgery, University of Bari Aldo Moro, Bari, Italy

    Giuseppe Giudice

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Crudele, L., Cariello, M., Moschetta, A. (2023). Nutrition and Metabolism. In: Maruccia, M., Papa, G., Ricci, E., Giudice, G. (eds) Pearls and Pitfalls in Skin Ulcer Management. Springer, Cham. https://doi.org/10.1007/978-3-031-45453-0_47

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-45453-0_47

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-45452-3

  • Online ISBN: 978-3-031-45453-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation