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Zinc Update: Clinical aspects of zinc in wound healing

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Zinc is a very important trace element in the human body and its significance in health and disease is appreciated worldwide. It also assists as a cofactor in several transcription factors and enzyme systems that includes zinc-dependent matrix metalloproteinases augmenting auto-debridement and keratinocyte migration in wound repair. Zinc provides resistance to epithelial apoptosis via cytoprotection against bacterial toxins and reactive oxygen species, probably through antioxidant activity of the cysteine-rich metallothioneins. Zinc deficiency of dietary or hereditary cause might result in the pathological changes and delay in wound healing.

Oral supplementation of zinc can be beneficial and effective in treating zinc-deficient leg ulcer patients. However, its therapeutic efficacy in surgical patients needs further explanation. Topical administration of zinc seems to be superior to oral treatment because of its action in decreasing the superinfections and necrotic material through improved local defense systems and collagenolytic activity, and the sustained release of zinc ions stimulating epithelialization of wounds in normozincemic people.

Zinc oxide present in paste bandages can protect and soothe inflamed peri-ulcer skin. Zinc is transported through the skin from these formulations, while the systemic effects appear insignificant. Thus, the review article recommends that topical zinc treatment is underappreciated although clinical evidence highlights its importance in anti-infective action, auto-debridement and promotion of epithelialization.

Source: Lansdown AB, Mirastschijski U, Stubbs N, Scanlon E, Agren MS. Zinc in wound healing: theoretical, experimental, and clinical aspects. Wound Repair Regen. 2007;15(1):2-16. doi:10.1111/j.1524-475X.2006.00179.x

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