Role of the antioxidant effect of vitamin e with vitamin C and topical povidone-iodine ointment in the treatment of burns.

Objective. Burns represent a major health problem worldwide, with high mortality and morbidity and economic loss even with small burns. Changes in medical treatment protocols depending on a new mechanism involved in the pathogenicity of burns, i.e. oxidative stress (such as the use of povidone-iodine alone or in combination with vitamin E and vitamin C) may improve the outcome and reduce the economic loss. Patients and methods. Thirty-eight thermally injured patients of different age groups, sex, and occupation with different burn size, admitted to the burn unit in Baquba General Hospital, Iraq, were involved in this clinical trial. The patients were allocated to three groups: group A (8 patients), treated according to hospital policy; group B (17 patients), treated with topical povidone-iodine ointment; and group C (13 patients), treated with topical povidone-iodine ointment with systemic once daily 400 mg vitamin E and 500 mg vitamin C in addition to the classical antibiotic used by our hospital. In each group of oxidative stress parameters, the thyroid, liver, and kidney function test, microbiological studies, the mortality rate and healing time measurements, and economic studies were performed using standard methods. Results. Treatment with topical povidone-iodine ointment or in combination with systemic vitamin E and vitamin C was found to be of significant benefit in improving oxidative stress parameters, the mortality rate, healing time, and cost, and was free of any adverse thyroid, hepatic, or renal effects. Conclusion. Treatment of thermally injured patients with topical povidone-iodine ointment significantly improved oxidative stress parameters, indicating its antioxidant effect. Further investigation is needed to explain the exact mechanism by which povidone-iodine exerts this antioxidant effect. Treatment with topical povidone-iodine ointment alone or in combination with systemic vitamin E and vitamin C significantly improves the outcome of thermally injured patients in a safe way, thanks to the newly emerged mechanism - oxidative stress - involved in burns pathogenesis.