Vitamins and Minerals for Optimal Wound Healing after RNY?

I've been searching everywhere with no luck. My nutritionist doesn't have a clue. I had a small bowel obstruction/strangulation in Dec, had emergency surgery, got MRSA, the wound had to be opened again in another surgery 3 weeks ago (just the top, not the abdominal cavity.) Now I have a wound in my very flabby belly (after losing 150 lbs) that measures about 12 inches by 6 inches oval, and about an inch and half deep. I go to a wound care center once a week and have a nurse come to my house 2 times a week. I am on a wound vac negative pressure therapy. When I ask about diet, I am just told to eat 140 grams of protein daily. I've done some research about what vitamins and minerals are essential to wound care, but find nothing about the amounts needed for someone who has had a distal RNY.<br />
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I've even searched the plastics forums, thinking that wound dehesience is got to be common there, and guidelines must be somewhere, but I find nothing.<br />
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Right now, in addition to the recommended vitamins and minerals for RNY, I've added selenium, vitamin C, vitamin E, B6 and Vitamin K. I'm thinking about adding B5 and l Argenine. Does anyone know of any guide for gastric bypass patients wound healing? I also looked on the ASBMS website--I couldn't find anything.<br />
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I've got 6 months to a year of healing. It looks good now, but the improvements are so incremental. Any help is appreciated.<br />
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My wound http://tinypic.com/view.php?pic=axc15&s=6

As a distal RNY, you may be better following the DS vitiamin guidelines.  Protein is your rebuilding nutrient, which is why they have you taking so much of it. 

http://www.gblcreations.com/Resources/Gina/ProgramDRNY_ERNY_ BPDDS3-2010.pdf

 

I'd base it on your labs, personally.

What's your vitamin D level?  Low vitamin D (below 80, according to the Linus Pauling Institute) can affect wound healing.  How much D3 do you take?

Taking extra selenium, vitamin E and vitamin K won't help if you are deficient in those things, and might actually cause problems since we store extra of those in our bodies.

I'd just get a full set of labs done, if you haven't lately, and go from there.

Kelly, I haven't had labs done since July. I need to make an appt with my PCP and have them done again. My D was very low and I've been taking dry D3 1000 daily. My K and B6 were very low, as well, and I take supplementation in addition to my multivitamin. Wound care websites recommend the selenium, Vitamin C and zinc, among others.

I really need a full workup anyway, so it won't hurt to see my PCP. I was borderline septic when I had the surgery in Dec, and I am lucky to be alive and to have all my organs functioning--but I do think my liver is wonky because my taste is off---sweet tastes like bile from dry heaves. Yuck.

I just want to do everything possible to heal as quickly as I can. I still haven't gotten rid of the MRSA, even after 8 different antibiotics over several weeks. I have autoimmune issues and had pneumonia & shingles just 3 weeks before I had the SBO--so I am still working to get some strength and stamina. I'm not an invalid like I was a month ago, so I want to do everything I can to get well.

1000 IU D3 is a super low dose.  I have only known two RNY patients that could maintain a good level (at least 80) on less than 10,000 IU a day.  Many need more than that.  I have to take 50,000 IU D3 three times a week which works out to about 28,000 IU a day to keep my level around 100.  So if your level was very low in July and you've only been taking 1000 IU a day, it's probably very very very low now.  Definitely get labs done ASAP.

If that's the case, it is probably really, really low ;( I'm going to get labs done. I have an appt in April, but I don't think I should wait. 10000iu a day--wow, I'm really off the mark. I think my D was 12 in July--rock bottom. I have to dig out my labs out of my medical folder to be sure, but I know it was under 20.

I agree with everything Val and Kelly said, but thought I'd point out that you need to be taking the 'dry' formulation of A,D,E, and K. They're the fat-soluble vitamins and with a distal RNY you're malabsorbing a lot of fat---which means you're not absorbing these vitamins in their oil-based form.