INFLUENCE OF LARGE INTAKES OF TRACE-ELEMENTS ON RECOVERY AFTER MAJOR BURNS

Because Cu, Se, and Zn are involved in immune and antioxidative defens e mechanisms and tissue repair, deficiencies might aggravate complicat ions classically observed with bums. After measuring massive cutaneous trace element losses in 10 burn patients, our aim in this study was t o determine whether large intravenous intakes of Cu, Zn, and Se can mo dify serum trace element levels and recovery after major burns. Ten pa tients, aged 34 +/- 6 yr (mean F SD), admitted to the bums center of a Swiss university hospital with thermal bums on 41 +/- 9% of their bod y surface were studied prospectively, with trace element balance studi es from day 1 (D1) to D7 postinjury. Urine and blood samples were also collected on D10, D15, D20, and D25. The patients were divided into t wo groups of five and received either standard (group 1, control) or g reatly increased (group 2, treatment: 4.5 mg Cu, 190 mu g Se, and 40 m g Zn/day) trace element intakes. Energy and protein intake and wound t reatment were similar in both groups. The treatment group was characte rized by improved Cu, Se, and Zn status (increase in serum levels and various protein indicators), a much larger leukocyte increase between D4 and D14 (mainly neutrophils), and shorter hospital stay (45 days) c ompared with the untreated group (57 days). Grafting requirements were more extensive in group 1. Although severity of injury and wound trea tment were similar in the groups, the duration of hospitalization was lower in the treated group. Further studies are required to determine whether this is related to trace element supplementation.