S. Izadi1, R. Shine1, M. LaPelusa1, N. Patel1, S. Snyder1, J. Skubic1 1University of Texas Rio Grande Valley School of Medicine,Edinburg, TX, USA
Introduction: Vitamin A has long been suggested by surgeons as a potential treatment to improve wound healing post-operatively in patients on chronic steroids; however, optimal routes of administration and dosage recommendations in clinical practice remain unknown. This systematic review seeks to summarize the current evidence regarding this therapy and its effect on post-operative wound healing in patients on chronic steroid therapy.
Methods: A review was performed by searching multiple databases including PubMed, Medline, and Cochrane Library to identify clinical studies analyzing the use of Vitamin A and its effects on wound healing with concomitant steroid use.
Results: Eight animal clinical studies and ten human case reports were identified. Six clinical studies evaluated the effects of Vitamin A on wound healing, one evaluated healing in tracheal anastomosis, and one evaluated healing in intestinal anastomoses. Seven of the eight studies demonstrate significant wound healing benefits from intramuscular (1,000 IU/kg/day – 10,000 IU/kg/day) and topical (7,500 IU – 12,500 IU) Vitamin A treatments. In ten case reports of non-healing wounds secondary to steroid use, all reported dramatic improvement in wound healing with Vitamin A administration with no decreased efficacy of the parallel steroid therapy. Overall methodologic quality was good.
Conclusion: Vitamin A has shown promise in animal models by increasing the rate of wound healing and augmenting the strength of the healed tissues, without compromising the therapeutic effects of steroid therapy. Unfortunately, little research has been done regarding the efficacy of Vitamin A administration in humans with respect to wound healing; future studies are needed to help determine standardized protocols for this patient population.