31008
document
Trace element supplementation after major burns modulates antioxidant status and clinical course by way of increased tissue trace element concentrations . BACKGROUND After major burns , patients can develop nutritional deficiencies including trace element ( TE ) deficiencies . Various complications , such as infections and delayed wound healing , influence the clinical course of such patients . OBJECTIVES We aimed to investigate the effects of large , intravenous doses of TE supplements on circulating and cutaneous TE tissue concentrations , on antioxidant status , and on clinical outcome after major burns . DESIGN This was a prospective , randomized , placebo-controlled trial in 21 patients aged 35 +/- 11 y ( x +/- SD ) with burns on 45 +/- 21 % of their body surface area . Intravenous copper , selenium , and zinc ( TE group ) or vehicle ( V group ) was given with a saline solution for 14-21 d. Blood and urine samples were collected until day 20 , and skin biopsy specimens were collected on days 3 , 10 , and 20 . RESULTS The age of the patients and the severity of their burns did not differ significantly between the groups . Plasma TE concentrations were significantly higher in the TE group . In burned areas , skin contents of both selenium ( P=0.05 ) and zinc ( P=0.04 ) increased significantly by day 20 . Plasma and tissue antioxidant status was improved by supplementation . The number of infections in the first 30 d was significantly lower in the TE group ( P=0.015 ) , with a median number of 2 versus 4 infections per patient in the TE and V groups , respectively , as a result of a reduction in pulmonary infections ( P=0.03 ) . Wound healing was improved in the TE group , with lower requirements for regrafting ( P=0.02 ) . CONCLUSIONS TE supplementation was associated with higher circulating plasma and skin tissue contents of selenium and zinc and improved antioxidant status . These changes were associated with improved clinical outcome , including fewer pulmonary infections and better wound healing .
31009
Intervention_Pharmacological
Trace element supplementation
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Intervention_Pharmacological
TE supplements
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Intervention_Control
placebo-controlled
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Intervention_Pharmacological
Intravenous copper , selenium , and zinc ( TE group )
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Intervention_Control
vehicle
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Intervention_Pharmacological
TE
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Outcome_Physical
tissue trace element concentrations .
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Outcome_Physical
skin contents of both selenium
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Outcome_Physical
number of infections