From the Guidelines
Iron infusion is a crucial treatment for wound healing in patients with iron deficiency anemia, as it rapidly restores iron levels necessary for collagen synthesis, oxygen transport, and immune function. The most recent and highest quality study, 1, published in 2024, recommends intravenous iron supplementation for patients who cannot tolerate oral iron or have not shown improvement in blood counts or iron stores with oral iron. This study suggests that IV iron should be used in situations where oral iron is unlikely to be effective, such as in patients with impaired absorption due to bariatric surgery or active inflammatory bowel disease.
When considering iron infusion for wound healing, it is essential to choose a formulation that can replace iron deficits with 1 to 2 infusions, as these are preferred due to their efficacy and similar risks, as noted in 1. Common IV iron preparations include iron sucrose, ferric carboxymaltose, and iron dextran, with dosages varying depending on the severity of anemia. The goal of treatment is to normalize hemoglobin levels and replenish iron stores, with monitoring for potential side effects such as hypotension, nausea, or allergic reactions.
In terms of monitoring and adjusting treatment, a study from 2015, 1, suggests that post-treatment serum ferritin levels of >400 μg/L can prevent recurrence of iron deficiency within 1-5 years. However, the most recent guidance from 1 takes precedence, emphasizing the importance of individualized treatment based on patient response and the severity of anemia.
Key points to consider when using iron infusion for wound healing include:
- Rapid restoration of iron levels for collagen synthesis, oxygen transport, and immune function
- Choice of IV iron formulation based on efficacy, risk, and patient tolerance
- Monitoring for side effects, particularly with the first dose
- Individualized treatment goals based on patient response and severity of anemia
- Consideration of oral iron supplements as less effective in acute situations due to slower absorption and potential gastrointestinal side effects.
From the Research
Role of Iron Infusion in Wound Healing
- Iron infusion plays a crucial role in treating iron deficiency anemia, which can impact wound healing [(2,3,4,5,6)].
- Iron is essential for the production of hemoglobin, which carries oxygen to tissues, including wounds, promoting healing 6.
- Iron deficiency anemia can lead to impaired wound healing, and iron infusion can help correct this deficiency 6.
Mechanism of Iron Infusion in Wound Healing
- Iron infusion helps replenish iron stores, improving hemoglobin levels and oxygen delivery to tissues [(2,3,4,5)].
- Ferric carboxymaltose, a commonly used iron infusion, allows for controlled delivery of iron to target tissues 2.
- Iron infusion can also improve health-related quality of life, which is essential for optimal wound healing [(2,3)].
Clinical Evidence Supporting Iron Infusion in Wound Healing
- Studies have shown that iron infusion can rapidly improve hemoglobin levels and replenish depleted iron stores in patients with iron deficiency anemia [(2,3,4,5)].
- A retrospective observational study found that intravenous iron infusion using ferric carboxymaltose increased hemoglobin concentration by 18% in preoperative surgical patients with iron deficiency anemia 5.
- Another study highlighted the importance of iron in cutaneous wound healing, suggesting that iron deficiency can impair wound healing, while iron overload can have deleterious effects 6.