Al-Kaisy A A, Salih Sahib A, Al-Biati H A H K
Department of Surgery, Burn Unit, Baquba General Hospital, Diyala, Iraq.
Ann Burns Fire Disasters. 2006 Sep 30;19(3):115-22.
Many studies have reported that zinc plasma levels significantly decrease after a burn, leading to zinc deficiency, and that increased free radical generation and decreased natural antioxidant may negatively affect wound healing and burn outcome in general. Targeting of these changes is considered an important strategy in the treatment of burns in an attempt to improve burn outcome in the clinical setting. Zinc was given orally in a nutritional dose (15 mg elemental zinc) as a zinc sulphate capsule to burn patients in order to improve post-burn zinc deficiency and burn outcome. The study was carried out in 58 burn patients of different age groups, sex, and occupation with different burn size. The patients were allocated to two groups: group A patients (43 in number) were treated with topical povidone-iodine ointment for the first four days post-injury followed by topical silver sulphadiazine cream 1% until discharge in addition to other prescribed drugs according to our burn unit policy; group B patients (15) received the same treatment as group A plus a single daily oral dose of zinc sulphate in a 66 mg capsule, equivalent to 15 mg elemental zinc. In each group, using standard methods, we considered plasma zinc and copper levels, oxidative stress parameters, thyroid, liver, and renal function tests, microbiological factors, mortality rate, healing time, and cost effectiveness. The administration of zinc in dietary doses significantly increased the plasma zinc level in burn patients to around normal control levels and improved the antioxidant status, as represented by elevation of the natural antioxidant level (glutathione), in addition to improving healing time, the incidence of eschar formation, and the mortality rate, compared with the zinc-nonsupplemented group. We conclude that dietary zinc supplementation in zinc-deficient burn patients led to great improvements in their outcome and that zinc deficiency was as an important goal to target during treatment; also, that the use of a combination of topical and systemic antioxidants (povidoneiodine ointment and zinc sulphate, respectively) represented a good strategy for improving results in burn patient treatment.
许多研究报告称，烧伤后血浆锌水平会显著下降，导致锌缺乏，并且自由基生成增加和天然抗氧化剂减少可能会对伤口愈合及总体烧伤预后产生负面影响。针对这些变化进行干预被认为是烧伤治疗中的一项重要策略，旨在改善临床环境下的烧伤预后。为改善烧伤患者烧伤后的锌缺乏状况及烧伤预后，以营养剂量（15毫克元素锌）通过硫酸锌胶囊对烧伤患者进行口服补锌。该研究针对58名不同年龄组、性别和职业且烧伤面积各异的烧伤患者开展。患者被分为两组：A组患者（共43名）在受伤后的头四天使用聚维酮碘软膏进行局部治疗，之后使用1%的磺胺嘧啶银乳膏直至出院，此外还根据我们烧伤科的规定使用其他处方药；B组患者（15名）接受与A组相同的治疗，外加每日口服一粒66毫克胶囊的硫酸锌，相当于15毫克元素锌。在每组中，我们采用标准方法检测血浆锌和铜水平、氧化应激参数、甲状腺、肝脏和肾脏功能测试、微生物学因素、死亡率、愈合时间以及成本效益。与未补充锌的组相比，给予饮食剂量的锌显著提高了烧伤患者的血浆锌水平，使其接近正常对照水平，并改善了抗氧化状态，表现为天然抗氧化剂水平（谷胱甘肽）升高，此外还缩短了愈合时间，降低了焦痂形成的发生率和死亡率。我们得出结论，对缺锌的烧伤患者进行饮食补锌可使其预后得到显著改善，锌缺乏是治疗期间的一个重要靶向目标；此外，联合使用局部和全身抗氧化剂（分别为聚维酮碘软膏和硫酸锌）是改善烧伤患者治疗效果的良好策略。
