Additional Vitamin and Mineral Support for Patients with Severe Burns: A Nationwide Experience from a Catastrophic Color-Dust Explosion Event in Taiwan

Abstract

Major burn injuries, which encompass ≥20% of the total body surface area (TBSA), are the most severe form of trauma because of the stress response they provoke, which includes hypermetabolism, muscle wasting, and stress-induced diabetes. In 2015, a color-dust explosion disaster occurred in the Formosa Fun Coast of Taiwan and injured 499 people, who were transferred via a nationwide emergency delivery system. Some recommendations are currently available regarding vitamin and mineral support for wound healing and recovery in severe burns, but there is a lack of evidence to confirm the benefits. Thus, the current study aimed to investigate the effects of additional vitamin and mineral support for patients with severe burn injuries. Sixty-one hospitalized individuals with major burns (full thickness and ≥20% TBSA) were classified into the supplement (n = 30) and control (n = 31) groups, according to whether they received supplementation with additional vitamins, calcium, and magnesium. There were significant differences between the supplement and control groups in the incidence of wound infection (30.0% vs. 77.4%, p < 0.001), sepsis (13.3% vs. 41.9%, p = 0.021), and hospitalization days (51.80 vs. 76.81, p = 0.025). After adjustment, logistic regression analysis revealed that, compared to those in the control group, patients in the supplement group had a lower risk for wound infection (OR 0.11; 95% CI 0.03–0.43; p = 0.002) and sepsis (OR 0.09; 95% CI 0.01–0.61; p = 0.014). Supplementation of multiple vitamins, calcium, and magnesium reduced the risk of wound infection and sepsis, shortened the time of hospitalization, and can be considered for use in major burns.

Evidence-Based Nutritional Interventions in Wound Care

“…The authors reported a significant reduction in the length of hospitalization (51.8 days versus 76.8 days; p = 0.025), incidence of wound infection (30.0 percent versus 77.4 percent; p < 0.001), and sepsis (13.3 percent versus 41.9 percent; p = 0.021) in patients receiving daily oral vitamins A, B 1 , B 6 , B 12 , C, D, and E, combined with an infusion of 2% calcium chloride and an injection of 10% magnesium sulfate. 1…”

“…A standardized data abstraction form recorded the following information regarding each relevant study: (1) article author, (2) study design, (3) level of evidence, (4) number of patients, (5) nutrient evaluated, (6) delivery method evaluated, and (7) study outcomes.…”

Prevalence of vitamin D deficiency in burn patients: an observational study

“…They concluded that the supplementation of multiple vitamins, calcium, and magnesium reduced the risk of wound infection and sepsis and shortened hospitalization time. 15 Also, serum albumin concentrations are reduced following thermal damage, and can remain low for a long period of time. 16 A significant correlation was observed between the 25(OH)D levels and albumin in the present study, which is in concordance with this finding.…”

S3-Leitlinie Klinische Ernährung in der Chirurgie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) e. V.

“…Eine Verbesserung der Wundheilung bei brandverletzten Patienten wurde zudem gezeigt für die Gabe von Sojaöl [649] (1 + ), Vitaminen in Kombination mit Kalzium und Magnesium [650] (1 + ), Probiotika [651] (1 + ) und Olivenöl bei Beteiligung von 10-20 % der Körperoberfläche [652] (1 + ).…”