Pressure Wounds and Skin Failure Secondary Scurvy. Prevention with Early Vitamin Micro Nutrient Supplements

Skin is the largest organ of the body. The dermis is primarily collagen. A collagen deficit results in skin failure with thinning to the point of transparency and disruption. (pressure wounds). The media of blood vessels is also primarily collagen. Here a deficit causes capillary fragility and purpura. A collagen fiber is a triple strand of protein. Plates initially produce three strands of procollagen which twist around each other, first to the left, then right and left again. The result is a fiber more flexible and stronger than a steel wire of the same diameter. Strength is due to cross linking between fibers at the frequent amino acid proline and lysine positions after hydrogenation by vitamin C. It was observed that patients referred for pressure wound care had scurvy at the time of consult. Diagnosing a collagen, i.e. Vitamin C deficit during the admission skin assessment is straight forward by bed side observation for dermal atrophy, purpura or skin tears. If an ample profile of all micro-nutrients with 1 gm of vitamin C was started along with biofilm control and adequate wound dressings, the existing pressure wounds promptly improved and new wounds were prevented