Effects of Oral Cholecalciferol on Chronic Wound Healing in Patients with Vitamin D Insufficiency or Deficiency

口服胆钙化醇对维生素D不足或缺乏患者慢性伤口愈合的影响

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Abstract

BACKGROUND: Chronic wounds significantly impact patients' physical and mental health. Several individuals with chronic wounds have low vitamin D levels. Most previous studies have concentrated primarily on diabetic foot ulcers. Few investigations have explored the effects of vitamin D supplementation on different types of chronic wounds. PURPOSE: This study aimed to evaluate the impact of increasing serum 25-hydroxyvitamin D (25(OH)D) concentration on participants with chronic wounds and vitamin D insufficiency or deficiency following cholecalciferol (vitamin D3) supplementation. Additionally, it explored the combined effects of wound care and vitamin D supplementation on wound healing outcomes. PATIENTS AND METHODS: A total of 46 participants with chronic wounds who were admitted to a wound ostomy care clinic between February and December 2023 were enrolled and randomly assigned to intervention (n=23) and control (n=23) groups. Both groups received local wound treatment based on the tissue, infection, moisture, and edge (TIME) principles and were advised on dietary changes and sunlight exposure. The intervention group received 6000 international units (IUs) of oral cholecalciferol daily until week 5, after which doses were adjusted based on serum concentration. RESULTS: Of the 46 participants, 40 completed the study with 57 chronic wounds. Per-protocol analysis revealed a statistically significant difference in serum 25(OH)D concentration between the two groups at week 5 (mean ± standard deviation (SD): 36.75±7.23 vs 29.58±5.29 ng/mL, P<0.01). The intervention group had a shorter average wound healing time than the control group (mean ± SD: 15.59±6.27 vs 26.16±12.70 days, P<0.01). Additionally, wound area reduction rate, wound depth reduction rate, and pressure ulcer scale for healing (PUSH) scores were significantly higher in the intervention group (P<0.05). CONCLUSION: These findings suggest that oral cholecalciferol supplementation increases 25(OH)D concentrations and promotes chronic wound healing. TRIAL REGISTRATION: This trial was registered at the Chinese Clinical Trial Registry (https://www.chictr.org.cn/, Registration No. ChiCTR2200065482) on November 6, 2022.

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