Dr Sonia Hartog¹, Dr Tim T. Wang, Dr Jeon Cha

¹Royal North Shore Hospital, Sydney, Australia

Abstract:

Background: Supplementation with vitamins and micronutrients is routine at our institution for burns patients. The regime includes vitamin A, B, C and E as well as selenium and zinc. Burn injuries cause extensive depletion of micronutrients via increased urinary and cutaneous losses, as well as by inducing a catabolic metabolic state. This leads to decreased levels of vitamins and micronutrients, which are essential to wound healing, immune and neuromuscular function. However, there are no clear evidence-based guidelines for administration.

Methods: A systematic review was conducted to identify all studies published since 2000 which examine the impact of vitamin and micronutrient supplementation on outcomes including healing time, infection, length of stay, mortality and oxidative stress parameters. Quality of evidence was assessed according to GRADE criteria.

Results: Oral zinc supplementation improves tissue antioxidant status, healing time and mortality rate. High dose intravenous ascorbic acid administered in first 24-48 hours reduces resuscitation fluid requirement  and mortality . Studies with combined vitamin and micronutrient regimens showed reduced re-grafting, wound and respiratory infection rates and hospital length of stay.

Conclusion: Although all studies reported significant improvement in outcomes compared to control groups, extrapolation was limited by sample size and variation in supplement choice.  Further dedicated studies are required to inform future practice regarding specific supplements, dose and duration of therapy, as well as percentage TBSA at which supplementation is indicated.

Biography:

Surgical SRMO