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Skinnebenssår har gavn af D-vitamin

Skinnebenssår kan være svære at hele op, og behandling af denne sårtype koster samfundet mange penge. Derfor er alle tiltag der kan fremskynde opheling af skinnebenssår velkomne. Nu har forskere vist, at mange af disse patienter mangler D-vitamin, og at tilskud har en effekt.

En ny dobbelt-blindet placebokontrolleret undersøgelse udført på en karkirurgisk klinik med tilknytning til et universitetshospital i Brasilien har vist, at sårheling kan forbedres med D-vitamintilskud.

I undersøgelsen deltog 52 personer som blev delt i to grupper: 26 patienter med skinnebenssår og 26 patienter med tilsvarende alder, køn, blodtryk og tobaksforbrug, men uden skinnebenssår. I gruppen med skinnebenssår havde de 22 lavt D-vitamin i blodet. Gruppen med skinnebenssår og lavt D-vitamin blev igen delt. Ni forsøgsdeltagere fik placebo og 13 fik D-vitamin 50,000 IE (1.250 µg) om ugen i 2 måneder. Det svarer til knap 180 µg D-vitamin dagligt, hvilket absolut er en terapeutisk dosis.

Forskerne fandt ingen sammenhæng mellem sårenes størrelse og mængde af D-vitamin i blodet, men der var en tendens til bedre opheling i gruppen der fik D-vitamin. Det antages, at en større eller længerevarende undersøgelse med D-vitamin vil kunne forbedre resultatet yderligere.

Ref.

Burkiewicz CJ, et al. Vitamin D and skin repair: a prospective, double-blind and placebo controlled study in the healing of leg ulcers. Rev Col Bras Cir. 2012;39(5):401-7.

Kort om huden

Huden består af tre lag. Fra neden: Underhuden (subcutis), læderhuden (dermis) og overhuden (epidermis). Den øverste del af overhuden er et 10µm tyndt hornlag (Stratum corneum) der fungerer som barrierelag.

Sårheling sker i tre faser

  1. I første fase størkner blodet. Hvide blodlegemer bekæmper tilstedeværende bakterier. Fiberdannende celler vokser ind i såret og danner kollagen.
  2. I næste fase dannes granulationsvæv, som består af små, nydannede blodkar, bindevævsceller, hvide blodlegemer og plasmaceller.
  3. I sidste fase begynder der af dannes hud over granulationsvævet

Skinnebenssår

Skinnebenssår kan vare fra måneder til årtier. Når et skinnebennsår ikke vil hele op, skyldes det, at sårheling ikke kan gå til næste fase før den foregående er færdig. De blokerende faktorer kan være dødt væv og betændelse i såret, som granulationsvævet ikke kan vokse ind. Nedsat blodforsyning til vævet af forskellige årsager og dermed iltmangel som forhindrer kollegendannelse. Derudover åreforkalkning, der kradses i såret som medfører vævsskade og infektion.

Hyppigheden af skinnebenssår stiger 4 gange, når personens alder når over 65 år.

D-vitaminmangel er almindelig i flere aldersgrupper, men især ældre mennesker er tilbøjelige til at mangle dette vitamin. Det skyldes en kombination af nedsat indtagelse og optagelse sammen med en lille udsættelse for sollys.

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  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `has_categories` AS `s` INNER JOIN `has_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`293μs3.98KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT DISTINCT a.id, a.title, a.name, a.checked_out, a.checked_out_time, a.note, a.state, a.access, a.created_time, a.created_user_id, a.ordering, a.language, a.fieldparams, a.params, a.type, a.default_value, a.context, a.group_id, a.label, a.description, a.required, a.only_use_in_subform,l.title AS language_title, l.image AS language_image,uc.name AS editor,ag.title AS access_level,ua.name AS author_name,g.title AS group_title, g.access as group_access, g.state AS group_state, g.note as group_note FROM has_fields AS a LEFT JOIN `has_languages` AS l ON l.lang_code = a.language LEFT JOIN has_users AS uc ON uc.id=a.checked_out LEFT JOIN has_viewlevels AS ag ON ag.id = a.access LEFT JOIN has_users AS ua ON ua.id = a.created_user_id LEFT JOIN has_fields_groups AS g ON g.id = a.group_id LEFT JOIN `has_fields_categories` AS fc ON fc.field_id = a.id WHERE ( (`a`.`context` = :context AND (`fc`.`category_id` IS NULL OR `fc`.`category_id` IN (:preparedArray1,:preparedArray2,:preparedArray3)) AND `a`.`access` IN (:preparedArray4,:preparedArray5)) AND (`a`.`group_id` = 0 OR `g`.`access` IN (:preparedArray6,:preparedArray7)) AND `a`.`state` = :state) AND (`a`.`group_id` = 0 OR `g`.`state` = :gstate) AND `a`.`only_use_in_subform` = :only_use_in_subform AND `a`.`language` IN (:preparedArray8,:preparedArray9) ORDER BY a.ordering ASC315μs4.81KBParams/libraries/src/MVC/Model/BaseDatabaseModel.php:166Copy
  • SELECT `alias` FROM `has_content` WHERE `id` = :id95μs1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `has_content` WHERE `id` = :id64μs1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `m`.`id`,`m`.`title`,`m`.`module`,`m`.`position`,`m`.`content`,`m`.`showtitle`,`m`.`params`,`mm`.`menuid` FROM `has_modules` AS `m` LEFT JOIN `has_modules_menu` AS `mm` ON `mm`.`moduleid` = `m`.`id` LEFT JOIN `has_extensions` AS `e` ON `e`.`element` = `m`.`module` AND `e`.`client_id` = `m`.`client_id` WHERE ( ( (`m`.`published` = 1 AND `e`.`enabled` = 1 AND `m`.`client_id` = :clientId AND `m`.`access` IN (:preparedArray1,:preparedArray2)) AND (`m`.`publish_up` IS NULL OR `m`.`publish_up` <= :publishUp)) AND (`m`.`publish_down` IS NULL OR `m`.`publish_down` >= :publishDown)) AND (`mm`.`menuid` = :itemId OR `mm`.`menuid` <= 0) AND `m`.`language` IN (:preparedArray3,:preparedArray4) ORDER BY `m`.`position`,`m`.`ordering`2.21ms261.84KBParams/libraries/src/Cache/Controller/CallbackController.php:51Copy
  • SELECT `a`.`id`,`a`.`title`,`a`.`catid`,`a`.`language`, CASE WHEN CHAR_LENGTH(`a`.`alias`) != 0 THEN CONCAT_WS(':', `a`.`id`, `a`.`alias`) ELSE a.id END AS `slug`, CASE WHEN CHAR_LENGTH(`cc`.`alias`) != 0 THEN CONCAT_WS(':', `cc`.`id`, `cc`.`alias`) ELSE cc.id END AS `catslug` FROM `has_content` AS `a` LEFT JOIN `has_categories` AS `cc` ON `cc`.`id` = `a`.`catid` WHERE `a`.`catid` = :catid AND `a`.`state` = :state AND `a`.`access` IN (:preparedArray1,:preparedArray2) AND (`publish_up` IS NULL OR `publish_up` <= :nowDate1) AND (`publish_down` IS NULL OR `publish_down` >= :nowDate2) AND `a`.`language` IN (:preparedArray3,:preparedArray4) ORDER BY CASE WHEN `a`.`publish_up` IS NULL THEN `a`.`created` ELSE `a`.`publish_up` END DESC8.58ms161.75KBParams/plugins/content/pagenavigation/src/Extension/PageNavigation.php:188Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug` FROM `has_categories` AS `s` INNER JOIN `has_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`294μs3.98KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT custom_data FROM has_extensions WHERE element = 'yootheme' AND folder = 'system' LIMIT 1126μs536B/templates/yootheme/packages/platform-joomla/src/Storage.php:30Copy
  • SELECT `language`,`id` FROM `has_menu` WHERE `home` = '1' AND `published` = 1 AND `client_id` = 0306μs704B/libraries/src/Language/Multilanguage.php:123Copy
  • SELECT `alias` FROM `has_content` WHERE `id` = :id104μs1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `alias` FROM `has_content` WHERE `id` = :id60μs1.31KBParams/components/com_content/src/Service/Router.php:168Copy
  • SELECT `c2`.`language`,CONCAT_WS(':', `c2`.`id`, `c2`.`alias`) AS `id`,CONCAT_WS(':', `ca`.`id`, `ca`.`alias`) AS `catid` FROM `has_content` AS `c` INNER JOIN `has_associations` AS `a` ON `a`.`id` = `c`.`id` AND `a`.`context` = :context INNER JOIN `has_associations` AS `a2` ON `a`.`key` = `a2`.`key` INNER JOIN `has_content` AS `c2` ON `a2`.`id` = `c2`.`id` INNER JOIN `has_categories` AS `ca` ON `c2`.`catid` = `ca`.`id` AND `ca`.`extension` = :extension2 WHERE `c`.`id` = :id AND c2.access IN (1,5) AND c2.language != 'da-DK' AND (c2.publish_up IS NULL OR c2.publish_up <= '2025-01-09 08:52:39') AND (c2.publish_down IS NULL OR c2.publish_down >= '2025-01-09 08:52:39') AND c2.state = 1249μs3.97KBParams/libraries/src/Language/Associations.php:145Copy
  • SELECT `c`.`id`,`c`.`asset_id`,`c`.`access`,`c`.`alias`,`c`.`checked_out`,`c`.`checked_out_time`,`c`.`created_time`,`c`.`created_user_id`,`c`.`description`,`c`.`extension`,`c`.`hits`,`c`.`language`,`c`.`level`,`c`.`lft`,`c`.`metadata`,`c`.`metadesc`,`c`.`metakey`,`c`.`modified_time`,`c`.`note`,`c`.`params`,`c`.`parent_id`,`c`.`path`,`c`.`published`,`c`.`rgt`,`c`.`title`,`c`.`modified_user_id`,`c`.`version`, CASE WHEN CHAR_LENGTH(`c`.`alias`) != 0 THEN CONCAT_WS(':', `c`.`id`, `c`.`alias`) ELSE `c`.`id` END as `slug`,( SELECT COUNT(`i`.`id`) FROM `has_content` AS `i` WHERE `i`.`catid` = `c`.`id` AND `i`.`state` = 1 AND `i`.`language` IN (:preparedArray5,:preparedArray6)) AS `numitems` FROM `has_categories` AS `s` INNER JOIN `has_categories` AS `c` ON (`s`.`lft` < `c`.`lft` AND `c`.`lft` < `s`.`rgt` AND `c`.`language` IN (:preparedArray3,:preparedArray4)) OR (`c`.`lft` <= `s`.`lft` AND `s`.`rgt` <= `c`.`rgt`) WHERE (`c`.`extension` = :extension OR `c`.`extension` = 'system') AND `c`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`published` = 1 AND `s`.`id` = :id ORDER BY `c`.`lft`8.65ms4.05KBParams/libraries/src/Categories/Categories.php:375Copy
  • SELECT `a`.`id`,`a`.`title`,`a`.`alias`,`a`.`introtext`,`a`.`fulltext`,`a`.`checked_out`,`a`.`checked_out_time`,`a`.`catid`,`a`.`created`,`a`.`created_by`,`a`.`created_by_alias`,`a`.`modified`,`a`.`modified_by`,CASE WHEN `a`.`publish_up` IS NULL THEN `a`.`created` ELSE `a`.`publish_up` END AS `publish_up`,`a`.`publish_down`,`a`.`images`,`a`.`urls`,`a`.`attribs`,`a`.`metadata`,`a`.`metakey`,`a`.`metadesc`,`a`.`access`,`a`.`hits`,`a`.`featured`,`a`.`language`,LENGTH(`a`.`fulltext`) AS `readmore`,`a`.`ordering`,`fp`.`featured_up`,`fp`.`featured_down`,CASE WHEN `c`.`published` = 2 AND `a`.`state` > 0 THEN 2 WHEN `c`.`published` != 1 THEN 0 ELSE `a`.`state` END AS `state`,`c`.`title` AS `category_title`,`c`.`path` AS `category_route`,`c`.`access` AS `category_access`,`c`.`alias` AS `category_alias`,`c`.`language` AS `category_language`,`c`.`published`,`c`.`published` AS `parents_published`,`c`.`lft`,CASE WHEN `a`.`created_by_alias` > ' ' THEN `a`.`created_by_alias` ELSE `ua`.`name` END AS `author`,`ua`.`email` AS `author_email`,`uam`.`name` AS `modified_by_name`,`parent`.`title` AS `parent_title`,`parent`.`id` AS `parent_id`,`parent`.`path` AS `parent_route`,`parent`.`alias` AS `parent_alias`,`parent`.`language` AS `parent_language`,COALESCE(NULLIF(ROUND(`v`.`rating_sum` / `v`.`rating_count`, 1), 0), 0) AS `rating`,COALESCE(NULLIF(`v`.`rating_count`, 0), 0) AS `rating_count` FROM `has_content` AS `a` LEFT JOIN `has_categories` AS `c` ON `c`.`id` = `a`.`catid` LEFT JOIN `has_users` AS `ua` ON `ua`.`id` = `a`.`created_by` LEFT JOIN `has_users` AS `uam` ON `uam`.`id` = `a`.`modified_by` LEFT JOIN `has_categories` AS `parent` ON `parent`.`id` = `c`.`parent_id` LEFT JOIN `has_content_frontpage` AS `fp` ON `fp`.`content_id` = `a`.`id` LEFT JOIN `has_content_rating` AS `v` ON `a`.`id` = `v`.`content_id` WHERE `a`.`access` IN (:preparedArray1,:preparedArray2) AND `c`.`access` IN (:preparedArray3,:preparedArray4) AND `c`.`published` = 1 AND `a`.`state` = :condition AND `a`.`catid` IN (:preparedArray5) AND (`a`.`publish_up` IS NULL OR `a`.`publish_up` <= :publishUp) AND (`a`.`publish_down` IS NULL OR `a`.`publish_down` >= :publishDown) AND `a`.`language` IN (:preparedArray6,:preparedArray7) ORDER BY RAND() ASC LIMIT 1528.33ms215.28KBParams/libraries/src/MVC/Model/BaseDatabaseModel.php:166Copy
  • SELECT MAX(`tag_id`) AS `tag_id`,COUNT(*) AS `count`,MAX(`t`.`title`) AS `title`,MAX(`t`.`access`) AS `access`,MAX(`t`.`alias`) AS `alias`,MAX(`t`.`params`) AS `params`,MAX(`t`.`language`) AS `language` FROM `has_contentitem_tag_map` AS `m` INNER JOIN `has_ucm_content` AS `ucm` ON `m`.`content_item_id` = `ucm`.`core_content_item_id` AND `m`.`type_id` = `ucm`.`core_type_id` INNER JOIN `has_categories` AS `cat` ON `ucm`.`core_catid` = `cat`.`id` INNER JOIN `has_tags` AS `t` ON `tag_id` = `t`.`id` INNER JOIN `has_ucm_content` AS `c` ON `m`.`core_content_id` = `c`.`core_content_id` WHERE `t`.`access` IN (:preparedArray1,:preparedArray2) AND `t`.`published` = 1 AND `cat`.`published` > 0 AND `t`.`language` IN (:preparedArray3,:preparedArray4) AND `m`.`type_alias` = `c`.`core_type_alias` AND `c`.`core_state` = 1 AND (`c`.`core_access` IN (:preparedArray5,:preparedArray6) OR `c`.`core_access` = 0) AND (`c`.`core_publish_up` IS NULL OR `c`.`core_publish_up` = :nullDate2 OR `c`.`core_publish_up` <= :nowDate2) AND (`c`.`core_publish_down` IS NULL OR `c`.`core_publish_down` = :nullDate3 OR `c`.`core_publish_down` >= :nowDate3) GROUP BY `tag_id`,`t`.`title`,`t`.`access`,`t`.`alias` ORDER BY RAND() LIMIT 1545.97ms2.75KBParams/modules/mod_tags_popular/src/Helper/TagsPopularHelper.php:183Copy
  • SELECT `c2`.`language`,`c2`.`id` FROM `has_menu` AS `c` INNER JOIN `has_associations` AS `a` ON `a`.`id` = `c`.`id` AND `a`.`context` = :context INNER JOIN `has_associations` AS `a2` ON `a`.`key` = `a2`.`key` INNER JOIN `has_menu` AS `c2` ON `a2`.`id` = `c2`.`id` WHERE `c`.`id` = :id237μs1.44KBParams/libraries/src/Language/Associations.php:145Copy
  • SELECT `name`,`element` FROM `has_extensions` WHERE `type` = 'plugin' AND `folder` = 'finder' AND `enabled` = 1165μs640B/administrator/components/com_finder/src/Helper/LanguageHelper.php:135Copy
  • SELECT `title` FROM `has_finder_taxonomy` WHERE `parent_id` = 1 AND `state` = 1 AND `access` IN (1,5)133μs584B/administrator/components/com_finder/src/Indexer/Taxonomy.php:314Copy
  • SELECT DISTINCT a.id, a.title, a.name, a.checked_out, a.checked_out_time, a.note, a.state, a.access, a.created_time, a.created_user_id, a.ordering, a.language, a.fieldparams, a.params, a.type, a.default_value, a.context, a.group_id, a.label, a.description, a.required, a.only_use_in_subform,l.title AS language_title, l.image AS language_image,uc.name AS editor,ag.title AS access_level,ua.name AS author_name,g.title AS group_title, g.access as group_access, g.state AS group_state, g.note as group_note FROM has_fields AS a LEFT JOIN `has_languages` AS l ON l.lang_code = a.language LEFT JOIN has_users AS uc ON uc.id=a.checked_out LEFT JOIN has_viewlevels AS ag ON ag.id = a.access LEFT JOIN has_users AS ua ON ua.id = a.created_user_id LEFT JOIN has_fields_groups AS g ON g.id = a.group_id WHERE ( (`a`.`context` = :context AND `a`.`access` IN (:preparedArray1,:preparedArray2)) AND (`a`.`group_id` = 0 OR `g`.`access` IN (:preparedArray3,:preparedArray4)) AND `a`.`state` = :state) AND (`a`.`group_id` = 0 OR `g`.`state` = :gstate) AND `a`.`only_use_in_subform` = :only_use_in_subform AND `a`.`language` IN (:preparedArray5,:preparedArray6) ORDER BY a.ordering ASC307μs4.75KBParams/libraries/src/MVC/Model/BaseDatabaseModel.php:166Copy
  • SELECT `title` FROM `has_finder_taxonomy` WHERE `parent_id` = 1 AND `state` = 1 AND `access` IN (1,5)129μs584B/administrator/components/com_finder/src/Indexer/Taxonomy.php:314Copy
  • SELECT SUM(CASE WHEN `a`.`next_execution` <= :now THEN 1 ELSE 0 END) AS due_count,SUM(CASE WHEN `a`.`locked` IS NULL THEN 0 ELSE 1 END) AS locked_count FROM `has_scheduler_tasks` AS `a` WHERE `a`.`state` = 1141μs1.37KBParams/administrator/components/com_scheduler/src/Model/TasksModel.php:466Copy
  • SELECT `session_id` FROM `has_session` WHERE `session_id` = ?88μs1KBParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:291Copy
  • UPDATE `has_session` SET `data` = ? , `time` = ? WHERE `session_id` = ?3.9ms592BParams/libraries/vendor/joomla/session/src/Handler/DatabaseHandler.php:318Copy