The clinical studies below reference the relationship between zinc and wounds.
Clinical studies
| Author/Journal | Study Object | Participants | Results |
| Kohn,25 2000 | 50 mg elemental zinc X 4 months in elderly with pressure ulcers and low plasma zinc levels |
4 | 80% to 100% healing of ulcersLow serum copper in 1 subject |
| Haeger,26 1974 | 140 mg elemental zinc vs. placebo X 40 days in chronic venous leg ulcers |
29 | Faster healing in zinc supplement group |
| Hallbrook,27 1972 | 140 mg elemental zinc vs. placebo X 40 days in chronic venous leg ulcers |
27 | Faster healing in zinc supplement group if serum below 110 mcg/dl pre-study |
| Pories,28 1967 | 150 mg elemental zinc vs. placebo X 6-9 weeks in post-surgical sinus tracts of young airmen |
20 | 3x faster healing in the supplement group |
Who to supplement?
Zinc deficiency is one of the nutritional deficiencies more frequently observed because although a body pool exists, body stores do not. Given the difficulty in measuring zinc status and the evidence supporting zinc supplementation for wound healing in deficiency states, the best strategy at present may be to identify wound patients with clinical manifestations of deficiency (Figure 1) or those suspected of being deficient.
Figure 1. Clinical Manifestations of Zinc Deficiency
| Growth Retardation | Hair loss | Corneal edema |
| Skin Rash | Ataxia | Glucose intolerance |
| Diarrhea | Impaired Wound Healing | Hypogeusia |
| Hypospermia | Behavioral changes | Night blindness |
Eighty percent of zinc found in foods comes from meat, fish, poultry, whole grains and milk. Despite a plentiful and relatively inexpensive food supply, Prasad et al. found 30 percent of healthy well-educated elderly deficient in zinc as measured by granulocyte and lymphocyte levels. Thirteen subjects treated with 30 mg of elemental zinc for six weeks achieved normal zinc levels without derangements in copper status. Possible causes for low intake in the elderly are cost, chewing problems and dislike of zinc-rich foods.
Figure 2 shows a wide variety of conditions associated with zinc deficiency. Many are gastrointestinal-related as the intestine is the major route of zinc excretion. Increased urinary excretion of nitrogen during conditions of stress is associated with increased urinary loss of zinc. Also note that high concentrations of amino acids in parenteral nutrition increase the fraction of amino acid bound zinc and increase losses via the urine.
Figure 2. Conditions Associated with Zinc Deficiency
| Malabsorptive Diseases: Crohns, Chronic Diarrhea, SBS, HIV, celiac, bypass, pancreatic insufficiency |
Sickle Cell Anemia | Nephrotic Syndrome |
| Extensive burns, trauma, major surgery, sepsis | Alcohol abuse | Diabetes |
| Acrodermatitis enteropathica | Cystic fibrosis | Malnutrition |
| Drugs: penicillamine, sodium valproate, diethylene, triamine pentacetate |
Enterocutaneous fistula | Pica |
| Dietary substances: phytate, high dietary fiber | Parenteral Nutrition |
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