Zinc- and copper-replacement therapy--a must in burns and scalds in children?

The author describes experiences gained in the zinc and copper serum concentration estimations in burned children. Without added substitution therapy the serum zinc concentration rises by 19.9% and the serum copper concentration by 5.8% in the course of time. If only zinc is substituted the values rises by 83.6% for zinc, but the value for copper decreases by 18.8%. If the serum zinc and copper concentration is low on admission and if both added zinc and copper are given, the concentration for zinc rises by 102.5%, but the concentration of copper only rises by 25% and does not reach normal values. Serum zinc and copper concentration drops to its maximal extent 48 hours after the accident. The time of hospitalisation calculated per percentage of burned body surface decreases slightly if substitution therapy is given, although the average serum zinc and copper values do not even reach normal levels. The rate of infection and the type of infection are not markedly different whether no substitution, only zinc and copper serum concentration to the area of the burned body surface, the normal value, the dosages used in substitution therapy and the side effects of the therapy are discussed. Routine therapy is probably not justified because of the normal changes of the serum concentration, because side effects are not completely understood and because of the antagonism between zinc and copper known from veterinary medicine. If more than 20% of the total body surface has been burned zinc and copper deficiency is probable. The dosage referred to in the literature are too high and much lower dosages (10--30 mg of zinc sulphate per day and 0.08 mg/kg of copper sulphate per day) are advised. These amounts should be sufficient if given in addition to a diet, which should be administered as early as possible after the accident.