Learning Objective #1: understand how increasing consumption of omega-3 fatty acids in fish oil supplements may delay wound healing by decreasing pro-inflammatory cytokines.

Learning Objective #2: appreciate the monumental problem of nonhealing wounds in the United States and identify psychoneuroimmunological variables that affect healing.

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Purpose:  To examine effects of ω-3 fatty acids eicosapentaenoic (EPA) and docosahexaenoic (DHA), obtained from fish oil, on wound healing. The specific aims were: 1) to compare pro-inflammatory levels at blister sites between healthy individuals receiving ω-3 supplements and a control group; and 2) to compare wound healing between the two groups.  
 It was hypothesized that reducing pro-inflammatory cytokine production through consumption of ω-3 fatty acids could delay the necessary inflammatory stage of healing.
Design and Method:  A prospective, randomized, double-blind, experimental design included Group 1 (n=16), receiving ω-3 fatty supplements for four weeks prior to the blistering procedure and Group 2 (n=14), receiving a placebo for 4 weeks. The independent variable was ω-3 fatty acid supplements, which were biochemically confirmed by plasma per gas chromatography. Dependent variables were the inflammatory stage of healing measured by proinflammatory cytokines via enzyme-linked immunosorbent assay (ELISA) and wound healing determined by single digital camera photogrammetry. 
Pro-inflammatory cytokines were measured in blister serum at 5 and 24 hours post formation of 8 small blisters on nondominant forearm. Salivary cortisol and a Perceived Stress Scale evaluated stress levels, which can affect healing. Wound areas were measured daily until 100% healed.  Subjects completed 3-day food diaries at baseline and four weeks with micronutrients quantified by Nutrition Data System for Research (NDSR).
Preliminary Findings:  Subjects = 30 healthy individuals, 57% women and 43% male, (mean ± SD age, 25.4 ± 6.4 years). Ethnicity = 77% White, 13% Asian and 10% African American. Mean days to healing = 10.6 ± 3.6 days (active subgroup = 11.1 ± 4.4; placebo = 9.8 ± 2.1). Fatty acid, pro-inflammatory cytokine and salivary cortisol assays are in process, as are PSS scores and nutritional analyses.
Conclusions:  Pending the outcome, evidence may encourage discontinuation of supplemental ω-3 fatty acids prior to elective surgery.