title: Total Enteral Nutrition Facilitates Wound Healing Through Preventing Intestinal Atrophy, Keeping Protein Anabolism and Suppressing Inflammation.
abstract: BACKGROUND
  In clinical settings, early total enteral nutrition (TEN) is known to reduce the postoperative complication and infection rate as well as duration of postoperative stay compared with total parenteral nutrition (TPN) in a variety of critical conditions. We aimed to compare effects TEN and TPN on wound healing and explore its possible mechanisms using rat model.
  
  
  METHODS
  Seven days after operation for inserting enteral tube into gastric space for TEN, Sprague-Dawley rats were made burn (15 mm) in the back. Rats were administrated with either TEN (N = 17) or TPN (N = 15) and evaluated condition of wound healing as well as serum/urine immunological and biochemical parameters at 28 days.
  
  
  RESULTS
  Burned area was significantly reduced in TEN than in TPN group. Although body weight, serum levels of total protein, albumin and transferrin were the same levels between the two groups, urine nitrogen and intestinal atrophy were significant in TPN group. Conversely, weight of small bowel showed positive linear relationship with levels of parameters calculated as follows: [medication nitrogen quantity - (urine nitrogen + feces nitrogen)]/[medication nitrogen - feces nitrogen quantity]. Weights of spleen and tumor necrotizing factor-a levels in serum were higher in TPN than in TEN.
  
  
  CONCLUSIONS
  These results suggest that TEN may facilitate wound healing compared with TPN through preventing intestinal atrophy, keeping protein anabolism and suppressing inflammation.
authors.affiliation: Department of Surgery, International University of Health and Welfare.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Surgery, International University of Health and Welfare.
authors.forename: Naruo
authors.initials: N
authors.lastname: Kawasaki
authors.affiliation: Division of Clinical Research & Development, Jikei University School of Medicine.
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Urashima
authors.affiliation: Department of Surgery, International University of Health and Welfare.
authors.forename: Hironori
authors.initials: H
authors.lastname: Odaira
authors.affiliation: Department of Surgery, International University of Health and Welfare.
authors.forename: Takuji
authors.initials: T
authors.lastname: Noro
keywords: Cytokine; Rats; Total enteral nutrition; Total parenteral nutrition; Wound healing