L-arginine improves wound healing after trauma-hemorrhage by increasing collagen synthesis

F. Wittmann, N. Prix, S. Mayr, P. Angele, M. W. Wichmann, N. K. Van Den Engel, T. Hernandez-Richter, I. H. Chaudry, K. W. Jauch, Martin K. Angele

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32 Citations (Scopus)


Background: Several studies indicate impaired wound healing after trauma and shock. Wound immune cell dysfunction seems to be responsible for altered wound healing after trauma-hemorrhage (T-H). In this respect, administration of the amino acid L-arginine normalized wound immune cell fraction under those conditions. It remains unknown, however, whether L-arginine improves impaired wound healing after T-H. Methods: To study this, male C3H/HeN mice were subjected to a midline laparotomy (i.e., soft tissue trauma induced), and polyvinyl sponges were implanted subcutaneously at the wound site before hemorrhage (35 ± 5 mm Hg for 90 minutes) or were subjected to sham operation. During resuscitation, mice received 300 mg/kg body weight L-arginine or saline (vehicle). Seven days thereafter, hydroxyproline (OHP), a metabolite of collagen synthesis, was measured in the wound fluid using high-performance liquid chromatography. Collagen types I and III were determined in the wound by Western blot analysis. In addition, wound breaking strength was measured 10 days after T-H or sham operation. Results: The results indicate that OHP was significantly decreased in T-H mice. L-Arginine, however, restored depressed OHP in the wound fluid in the T-H animals. Similarly, L-arginine treatment prevented a significant depression of collagen I synthesis after T-H. Collagen III was not significantly affected by T-H or L-arginine. Most important, L-arginine increased maximal wound breaking strength after severe blood loss. Therefore, L-arginine improves wound healing after T-H by increasing collagen synthesis. Conclusion: Because L-arginine improves wound healing, the results suggest that L-arginine might represent a novel and useful adjunct to fluid resuscitation for decreasing wound complications after trauma and severe blood loss.

Original languageEnglish
Pages (from-to)162-168
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number1
Publication statusPublished - Jul 2005
Externally publishedYes


  • Collagen I/III
  • Hemorrhage
  • Hydroxyproline
  • Wound breaking strength
  • Wound healing


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