Purpose: To increase the rate of healing following surgery and to minimize scar and adhesion formation.

Nutrients that promote healing include vitamin C, copper, vitamin A, and B-complex vitamins. Nutrients that reduce scar formation or adhesions include vitamin E and flavonoids. Vitamin E alone inhibited wound healing in one study, but that effect was reversed by addition of vitamin A. In another study, vitamin E alone accelerated wound healing.

Individuals who follow this program typically heal much faster than normal, with less pain and swelling and fewer complications.

Suggested Program (begin 2-4 weeks prior to surgery and continue for 4-6 weeks after surgery):

1. High-potency multiple vitamin and mineral formula.

   Additional supplements. Note: the dosages of the following may be reduced according to the amounts present in the multiple vitamin and mineral formula.

2. Vitamin C, 1,000mg, 2-3 times a day.

3. Vitamin E, 400 IU/day.

4. Vitamin A, 25,000 IU/day.

5. Zinc (picolinate or citrate), 30-50 mg/day.

6. Copper, 2-3 mg/day.

7. Flavonoids (choose one):
   • Citrus bioflavonoids, 500-1,000 mg, 2-3 times a day.
   • "Herbal Flavonoids" (Enzymatic Therapy; contains flavonoids from various fruit skins), 2-3 capsules per day.
   • Centella asiatica (standardized to contain 40% asiaticoside), 30 mg, 1-2 capsules twice daily.

8. Proteolytic enzymes are recommended to reduce inflammation and swelling at the surgical site and to promote reabsorption of fibrin and other tissue debris. Choices include (choose one):
   • Pancreatin, 1,400 mg, 2-3 capsules, 3 times a day. (between meals)
   • Bromelain (2,000 mcu/g), 250 mg, 2-3 capsules, 3 times a day. (between meals)

   Proteolytic Enzymes may be started 1-2 days before surgery or immediately after surgery and should be continued for 4-7 days after surgery. The dosage may be reduced by half after the third postoperative day.

by Alan R. Gaby, M.D. and Jonathan V. Wright, M.D.