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Table 1 Summary of the main findings of the research

From: The role of antioxidant micronutrients in the rate of recovery of burn patients: a systematic review

Author and country Study designs Aim of the study Micronutrients involved and concentrations Severity of burns (TBSA) Age of patients Outcomes Gaps
Berger et al., Switzerland [6] Randomized controlled trials (clinical trials)
(n = 21)
To investigate the effect of large intravenous doses of trace element supplements on circulatory, antioxidant status, and the clinical outcomes after major burns a) Copper (3.75 mg in IV and 2.7 mg in feeds)
b) Zinc (37.5 mg in IV and 21.5 mg in feeds)
c) Selenium (375 μg in IV and 90 mg in feeds)
Greater or equal to 10 %: greater than 20 % 16 to 65 years • Higher circulation of plasma and skin tissue contents of selenium and zinc
• Decreased pulmonary infection
• Better wound healing
• Multicenter studies should be done
Berger et al., Switzerland [5] Randomized controlled trials (clinical trials)
(n = 21)
To assess the effects of trace element supplements on systemic substrate turnover and local protein metabolism during wound healing after major burns a) Copper (59 μmol)
b) Selenium (4.8 μmol)
c) Zinc (574 μmol)
Greater or equal to 10 %: greater than 20 % 16 to 65 years • Increase skin tissue concentration of selenium and zinc
• Decrease protein catabolism
• Multicenter studies should be done
Berger et al.,
Switzerland [4]
Randomized controlled trials (clinical trials)
(n = 41)
To determine the effect of trace element supplementation on nosocomial or intensive care unit-acquired pneumonia a) Copper (2.5 to 3.1 mg/day)
b) Zinc (26.2 to 31.4 mg/day)
c) Selenium (315 to 380 μg/day)
Greater than 20 % 16 to 65 years • Reduced pulmonary infections
• Normalized plasma GSHPx activity, increased tissue selenium and zinc concentrations
• An improved wound healing
• A reduction in length of stay
• Dose response study should be done
Berger et al.,
Switzerland [9]
Randomized controlled trials (clinical trials)
(n = 20)
To determine the effects of trace element supplementation after burn injury a) 40.4 μmol of copper
b) 406 μmol of zinc
c) 2.9 μmol of selenium
Greater than 30 % 21 to 60 years • Decrease broncho-pneumonial infections
• Decrease hospital stay
• A better understanding of the effects of trace elements on neutrophil function and the acute phase response should be investigated
Al-Kaisy et al.,
Iraq [8]
Randomized controlled trials (clinical trials)
(n = 58)
To determine the effect of zinc on recovery rate of burn patients a) 15 mg of zinc 15 to 70 % 6 to 67 years • Increase in antioxidant status as evidence by increase in GSH concentration
• Decrease healing time
• None stated
Sahib et al.,
Iraq [7]
Randomized controlled trials (clinical trials)
(n = 180)
To know the effects of various antioxidants on the recovery of burn patients a) 400 mg of vitamin E and 500 mg of vitamin C/day
b) 75 mg of zinc sulfate/day
c) 100 mg of allopurinol/day
d) 3 mg of melatonin/day
e) 500 mg of N-acetylcysteine/day
15 to 40 % Not stated • Reduced incidence of infection
• Reduced wound healing time and decrease in mortality rate
• None stated
Al-Jawad et al.,
Iraq [2]
Randomized controlled trials (clinical trials)
(n = 60)
To explore the variable effects of N-acetylcysteine on wound healing in burn patients N-acetylcysteine
(500 mg/day)
15 to 40 % 20 to 40 years • Decrease time of hospital stay
• Decreased healing time
• None stated
Calds-Courtis et al.,
Canada [14]
Prospective cross-sectional
(n = 23)
To know the effect of vitamins C and E and zinc on oxidative stress on burn patients a) Ascorbic acid (1000 mg/day)
b) Zinc (50 mg/day)
10 to 93 % 17 to 80 years • Zinc concentration returned to normal values after 3 weeks
• Zinc supplementation did not have adverse effect on serum copper concentration
• Supplementation did not lead to gastrointestinal side effects
• None stated
Barbosa et al.,
Brazil [15]
Randomized controlled trials (clinical trials)
(n = 32)
To know the duration of zinc supplementation and the effects it has on gastrointestinal side effects a) Vitamin C (600 to 2700 mg)
b) Vitamin E (270 to 1080 mg)
c) Zinc (6 to 22 mg)
Greater than 10 % 2 to 15 years • Decrease in wound healing time • Dose response studies should be done
Rock et al.,
USA [16]
Prospective randomized trials
(n = 27)
To know the effect of the intake of carotenoids a) Beta carotene (30 mg/day) Greater than 20 % 18 to 65 years • Increase in plasma concentration of beta carotene • A study to know the ability of antioxidant micronutrients to influence risk of secondary tissue injury and disease should be explored
Zhang et al. [10] Randomized controlled trials (n = 35) To know the effect of vitamin E on lipid peroxidates Vitamin E (100 mg/day) Severe burns: greater than 10 % 14 to 62 years • Concentrations of vitamin E increased while lipid peroxides decreased • Antioxidant therapy in burn patients should be explored
  1. TBSA total body surface area; GSH glutathione