Effect of Absolute and Partial Vitamin C Deficiency on Healing of Wounds. ∗

Abstract

It is now well established that the intercellular substances in general, and the collagen of all fibrous tissue structures in particular require ascorbic acid for their production and maintenance. Aschoff and Koch 1 made thorough postmortem studies of World War soldiers who had died of scurvy, and demonstrated constant pathological changes in the supporting tissues of the body. Höjer 2 found a general atrophy of the connective tissue in scorbutic guinea pigs, and pointed out for the first time a general deficiency in the formation of collagen. In a series of more recent communications Wolbach 3 4 5 and his collaborators confirmed the observations of Höjer, and conclusively showed that ascorbic acid is intimately concerned with the synthesis and maintenance of intercellular supporting materials. Jeney and Törö, 6 when they added ascorbic acid to the nutrient medium of a culture of fibroblasts in vitro, found a marked increase in the number of collagen fibrils that were produced.

Since the repair and tensile strength of soft tissue wounds are direct functions of fibroblastic proliferation and collagen formation, it is at once apparent that Vitamin C may play a prominent rôle in the phenomenon of wound healing. Saitta 7 reported a delayed healing of exposed surface wounds in guinea pigs that had been kept on a Vitamin C deficient diet for more than 15 days. On the other hand, when a Vitamin C containing extract was applied directly to the wound, the healing time was appreciably diminished, regardless of whether the animals were maintained on a normal or a scorbutic dietary regime. He determined the rate of healing by actual daily measurements of the length and breadth of the wound.