Closing old wounds- a systematic review of the role of vitamin c in procedures and biopsies

Summary: Vitamin C, also known as ascorbic acid, has been found to be involved in wound healing pathogenesis. From the inflammatory phase by acting as a free radical scavenger to reduce oxidative stress, to the proliferative phase in which the synthesis, maturation and secretion of collagen takes place, to the maturation phase during which collagen production occurs throughout, vitamin C’s role in wound healing is inextricably linked to improved wound recovery ^[1]. Despite the abundance of well-documented evidence supporting vitamin C use in procedures and surgeries, its use in dermatology is mainly reserved for cosmetic purposes ^[2]. In dermatological and surgical specialties, vitamin C is not typically recommended as a post-procedural agent for improved recovery^[3], even though studies suggest that scar appearance and wound healing would benefit from vitamin C: an online search on three academic databases within Google Scholar, PubMed and Cochrane was conducted using the search terms “Vitamin C”, “Wound healing”, “Surgery”, “Post-operative” “Dermatology”, “Dermatology biopsies”, and “Melanoma” and a combination of these words to be able to capture the clinical and procedural landscape in which vitamin C is utilized, and where there is room for improvement in its utility. A total of 93 articles were initially screened, with the exclusion of 42 works that were out of scope and 4 articles that were not in English, leaving a total of 47 articles. Of the included articles, 40% involved vitamin c in cosmetic procedures, 25.5% in outpatient surgical procedures, 13% in skin care regimens, 8.5% in inpatient surgical procedures and 13% in wound healing. No articles discussed vitamin c use in biopsies or diagnostic tests within dermatology. The results suggest a significant opportunity for vitamin c to be employed in different practices within dermatology and healthcare. Consequently, the favorable properties of vitamin c in wound healing and in improved procedural outcomes are not being benefited from as a result of under utility and potential gaps in clinical practice. Ulysses Cázares¹, Akciree Knight¹, Ericka Knight¹ 1. Medicine, University of California Riverside, School of Medicine, Riverside, CA, United States. Stem Cell Biology, Tissue Regeneration and Wound Healing