Trace Element Supplementation Following Severe Burn Injury

Kurmis, Rochelle; Greenwood, John E.; Aromataris, Edoardo

doi:10.1097/bcr.0000000000000259

Cited by 45 publications

(19 citation statements)

References 30 publications

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“…Zinc deficiency has been linked to delayed wound healing [ 32 , 35 ] and low serum zinc levels have been reported in critically ill patients within Intensive Care Units [ 36 ]. Although the benefits of supplemental zinc have been documented in critically ill patients [ 37 ], severe burn injury [ 38 , 39 ], subcutaneous abscess, minor surgery [ 40 ] and pressure ulcers [ 41 , 42 ], the effects of zinc on wound healing has only been minimally reviewed [ 32 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

Zinc in Wound Healing Modulation

et al. 2017

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Wound care is a major healthcare expenditure. Treatment of burns, surgical and trauma wounds, diabetic lower limb ulcers and skin wounds is a major medical challenge with current therapies largely focused on supportive care measures. Successful wound repair requires a series of tightly coordinated steps including coagulation, inflammation, angiogenesis, new tissue formation and extracellular matrix remodelling. Zinc is an essential trace element (micronutrient) which plays important roles in human physiology. Zinc is a cofactor for many metalloenzymes required for cell membrane repair, cell proliferation, growth and immune system function. The pathological effects of zinc deficiency include the occurrence of skin lesions, growth retardation, impaired immune function and compromised would healing. Here, we discuss investigations on the cellular and molecular mechanisms of zinc in modulating the wound healing process. Knowledge gained from this body of research will help to translate these findings into future clinical management of wound healing.

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Section: Introductionmentioning

confidence: 99%

Zinc in Wound Healing Modulation

et al. 2017

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“…The elements that affect patient recovery from a major burn injury are multifactorial. However, nutritional support plays a critical role in the overall recovery of patients, which can be assessed by several indicators including wound healing, wound infection [ 13 , 14 ], sepsis, and number of days of hospitalization [ 4 , 7 , 14 ]. The results of the current study revealed that patients in the control group had a higher risk for wound infections (OR 9.46; 95% CI 2.31–38.69) and sepsis (OR 11.37; 95% CI 1.63–79.20).…”

Section: Discussionmentioning

confidence: 99%

“…Based on the viewpoint that micronutrients (vitamins and minerals) play an essential role in antioxidant defense, and that a deficiency will amplify the metabolic perturbations and ongoing catabolism already induced by the burns, there is a rationale for supplementation with micronutrients [ 2 , 5 ]. Some recommendations are available for the supplementation of vitamins and trace elements after a burn injury [ 2 , 3 , 14 ]. However, there is a lack of evidence to confirm the benefits of vitamin and mineral support for wound repair, healing, and physical recovery in patients with severe burns.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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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.

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“…Despite overwhelming evidence that delays in wound healing can be prominently caused by trace elements like zinc, other anti-oxidants like Vitamin A, C, and E have been implicated as well [43][44][45][46]. Many issues still remain unaddressed pertaining to the subject under review, such as the prevalence of inordinate delay in wound healing and the absence of reliable data on the economic burden it places on society in general and insurance industry in particular.…”

Section: Unanswered Questionsmentioning

confidence: 99%