Role of Vitamin C in Chronic Wound Healing

Vitamin C (ascorbate) is an essential micronutrient with many functions in the body. Wound healing is the complex physiologic process by which skin is repaired in response to injury. A number of biological activities of vitamin C may impact on wound healing. These include the promotion of collagen formation, the ability to regulate the inflammatory response, particularly neutrophil function, and the capacity of vitamin C to interact with cell signaling pathways. Hypoxia is an important determinant of healing outcomes, and the ability of vitamin C to regulate the transcription factor, hypoxia-inducible factor, is likely to influence the function of many cells during wound healing. There is evidence to suggest that the prolonged and severe deficiency of vitamin C observed in scurvy dramatically impairs wound healing. In this review, we discuss the biology of cutaneous wound healing and consider the evidence for the use of vitamin C to promote the healing of chronic wounds. Chronic wounds occur when the normal acute healing process becomes impaired or halts, often in the inflammatory phase, and they are a growing problem worldwide. Preliminary data suggest that many individuals with chronic wounds may be vitamin C deficient. However, the extent to which low vitamin C status contributes to the burden of chronic wounds is unknown, with only a handful of randomized controlled trials conducted to determine whether oral vitamin C supplementation can improve healing outcomes. More research is required to determine whether this vitamin could provide a simple and safe intervention for those with chronic wounds.