Escolar Documentos
Profissional Documentos
Cultura Documentos
AM
FhI(AN
.JoLRN;5I.
OF in (-I.
(LIxIc.sL
Nuiiurios
\1.
23, N.
VruUd
5, May,
1970, pp
514-519
Original
Communications
Zinc
Effects of Zinc
and
Deficiency
Wound
and
C.
DAVID
Healing
Zinc Supplementation12
H.
HAROLD
H.
SANDSTEAD,3
SHEPHARD,5
M.D.,
M.D.,
VERNE AND
LANIER,
JR.,4
M.D.,
GLENN
D.
GILL.E5PIE,0
B.A.
ZINC,
biological l)11t plays nucleic which enzyme oxytibonucleic (2, (1) role ciency strength skin vine The tial of of skill 3) by of
AN
NUTRiENT
for at a
higher
TI,,
WOUND TO HEALING
BURN OR 23
animals
has
it
two
PAIR FED CONTROL
functions: several an
acid!
is
metalloenzymes un!erstood
protein an(!
b)
(1),
it in metallodIeliver
DAYS 5
incompletely be
metai)ohsm
may
ind!epend!ent Its acid the utilization are examples as in a a surgical and delays of the processes, requirement synthesis
of in of of consequence
function. and! the for rat Perhaps, in these results of rats (6). practical usefulness patients tiiis
MATERIAlS
function.
3
DAY 6 TO 23
P <
.001
P<
001
zinc in
treatment healing
arc
Fic.
1. compared
of
/.inc-(lehcient for
an between area
and rate
of
control following
rats
poor wound
of
skin
excision (lifferences
or
thermal
are highly
burn.
signilicant.
The
prolnpte(!
the
means
METHODS
spraye! egg
white, PP
cages, given and!
biotin-cnriched
diet
constainin
female
were
fed
ision
male 20%
Spragueprotein,
<0.3
l)OttleS,
ziiic
(7,
glass
8),
housed in a
divided
d!istilhed
water
from
he t
1)is
Department
of Medi-
plastic dust-free
groups of
maintained
They were
relatively
into animals.
Vanderbilt
Tennessee
envirollmemit.
37203.
pair-fed
of each
ant!
were every
b Ser
(;rant 397,
and U.S.
member
animals,
of
the
ad
Lllite(l Public
Foun(lation
Professor
intraperitoneally
100 Two to
other after
(lay.
beginning
Assistant
wceks
Professor
of
Medicine.
Resident
11
in
when
Fisher
clinical
of
zinc
deficiency
Reference
Surgery.
.ssistant
Chief
to 1)r.
Resident Sandstead.
514
Zinc
and
\\ound
Healing
515
TABLE
Effect
of
zinc
deficiency
on
the
rate
of
the
closure
rat
of
open
surgical
wounds in the
integument
of
Day
0-5
or a
Day
to
healing
of
the
control
Pairs
Ti/?
K
Control
Deficient
Ti?
Control Deficient Control
I)eIicient
K
Con
Deficient
trcl
l
2
2.33 2.66
5.33 2.66
2.50
2.33 2.33
2.66 2.49
1.50
0.258 0261 0.132 0.261 0.346 0.390 0.346 0.308 0.308 0.346 0.288 0.385 0.173 0.288 0.385
0.258 0.258 0.261 0.278 0.462 0.390 0.346 0.390 0.396 0.265 0.389 0.433 0.385 0.408 0.408
6.49
8.66 Positive sloped 6.33 7.75 4.25 2.88 3.75
3.75
5.33 2.66 3.66 4.33 3.00 2.50 3.13 2.50 3.00 250 3.50
2.99
0.132
0.261
3
45
5e
0. 0.
188 1 6()
0.231
0.
163
0.346
0.222
7 8 10 11
1.75 2.00
2.25
1.75 2.00
1.75
1.75
2.62
12
1 3 14 15
3.10
2.70
3.60 3.40
2.65
2.95
0.261
l6c
0.233
Tli2
K 0.390 0.346 0.346 0.390 0.347 0.385 0.383 0.347 when ad controls. the wound
weanling Adult Iflale
T1i2 3.23 3.23 3.35 3.00 3 At) 3.40 3.00 3.40 closed. rats.
Weanling
a
K 0213 0.213
0.206
AL AL AL3
1 2
.
AL
AL5 AL6 AL7 AL8 T112 (log 5-16; 2
0.231
0.204 0.204 0.231 0.204 fractional
=
time
in AL libituin
days
=
K = 0-8 Days
female
closure groups in
libituin-fed
b
groups
rats.
d
included
calculation
of significance.
weight
secretions
gain,
on
scruffy whiskers)
appearance,
and
porphyrin
successive
experiments
in
10-sec, to the of
had thickness of
become
animals, a
evident
l/2-cm
in diameter
di-
thermal were
burn left
the
ameter,
nonzinc-supplemented circular,
full
of
skin
terior thigh. Time wounds was of closure poste-rate from ad the were a standard projected of the and
cut-outs
healing
white traced
weighed
paper and
on
outout.
was other of
animals, lines
The
pairs
subjected
to
balance two
their
weights
plotted
on
semiloga-
516
Sandstead
et
al.
a L,
.73
1 /:
2. rat,
Effect of
zinc
deficiency
on
closure
of
surgical
wounds in
of
the
rat.
The
zinc-defifollowing
XIIa,
is compared with its pair-fed control, .VIIb, and .\ll wounds were the same size when first excised.
an ad
eOlltrol atintervals
iithimi
of
was
it
ppLI
wound
for losure. (
i)etweeii
into
a 11(1
houset!
and
fed
ts
with
were closure
pireimteit1
excised
thc ii
calculated
time significance
areas k. lime
of rate ai)ove.
from
difference
lo
melmta ill
asertain
tion to rats,
time coiitril)ution
teimsile strength
was
(ieternmiime(!
c!ecribcd
norimma!
200-g
rats water,
were and
were was
fed
divided
Purina
into 400 supple-
rat in Zinc
deficiency pairs closure
Rl-:stLTs
chow,
given
tap
cages.
maintained
injected with i)een
were were
delayed
wOtln(!s
File\ of
of
i)
time
(Figs.
member
each
2),
to rates of
time of ani-
placet!
closet!
healing
tiotsal
by
interrtli)te(! 6
of tile of a
time tensile
time
tleternmined
llletimo(! ternliime closure
Savhov
effect
(9).
on
To
wound
de-
initial
normal
rat,
16
adult
maleswere
observation (iata
(P shows
< that
0.01). two
Inspecdeficient
Zinc
and
Wound
Healing
517
had
marked
in
wound
CONTROL
during
the the
during
time
ZINC SUPPLEMENTED
ZINC DEFICIENT
#{149}
of
trol
I).
the
pail-fed!
animals
control
closed!
and
a similar (Table
also
ad
libitum
i-ate (Table
con.
#{149} #{149}
at
The
them-mal
deficient
burns
animals
II)
(Fig.
closed!
I)
of
more
U)
300
. #{149}
#{149}
the
slowly
#{149} #{149}
-
r
#{149} #{149}
(P <
0.001) collti-ols.
tllan
did
i)Urlls
of
#{149}#{149}.
time
scured with
pair-fe(!
time time
scar
ob-
z
I 10
.-.-..
#{149}#{149}
#{149}
#{149}
extent
associated
postburn.
l)w-ns
time from
Consequently,
rate
closure
was
w
IU)
200
#{149}
#{149}
appraised Of 2) wounds
controls.
that is rats
#{149}
#{149}
interest ant! of
the
(Fig. the
w
-J
U)
zinc-deficient
tended
appeai-et! time
z
Ed I-
00
N.S.
<
.001
improve
Similarly,
TABLE
11
Fic.
effect
3. /iimc on the
zinc
supplementation
tensile incisions deficiency postoperative strengtim
had of (lorsunm
no healing
apparent 12 tlays
Effect
of
zinc
deficiency
on
rate
of
closure
of postoperative
coimtrast, similar
in
the
of
tensile
time
rat.
lim
of
a thermal
burn in the
TI!
integument
K
I
of rat a
decreased
strcimgtlm
I 2-day
wouimds.
supplementation
Control
did
not
improve
time
i-ate
rats.
7.0 2
3
3.9 3.3
4.2
0.099 0.105 0.141 0.105 0. 139 0.152 0146 0.163 0132 0.158 0.119 0.132 0.123
0.117 0.210 0.165 0.119 0. 178 0.173 0.277 0.193 0.213 0.192
of are
on
4 3 Ii 7 8
9
3.8 3.9 4.0 2.3 3.6 3.25 3.6 5.25 4.0 3.36
demonsti-ate of ptiiposes,
supplemelmtation
of improving ma 1.
Foi
l)Oite(!
nom-mal previously
comparison
(5)
3.25
4.4 5.8 3.23 3.33
10
11 12
0.132
0.173 0.141
strengths pair-feti
of
coiltmol
l2-t!ay wounds
rats
P05t0i)er;Lti\e
of zinc-d!eficient
are
included!
in
Fig.
3.
13
P <0.001
--
DISCUSSION
These
6-13
the
Pairs
observed
1-5
from
observed
frolu
dais
= =
6-23.
time in
Pairs
days rate
wound
of wotmnd
was
dats one-half
6-19.
T1 closed.
K fractional
closure
518
Sandstead
et
a!.
I.
FIG.
Conlmectlve
tissue
of
12-clay zinc
incisions
in
control wound
the
fewer
dorsal
integulnent fibroblasts
of
zinc-
deficlelst healing
and and
pair-fed decreased
control rate.
density of
in
the
area
of
compared
on
the right.
teIlsile sure.
strengtim
Previously
of we imealiimg deficiency
om that
do- t!etreasct! jectivelmess makes strengtim mals (5). Iimis nitely (10,
d!ellsit)
of tlmese
tell tative.
time
collagen.
1lme obviously
are,
sub-
of
t imeimi
observations
1imey
stieimgtim bs
not
of
imowever,
dietary
t!elay
zinc
Calorie consistent
in
tensile aimidefi-
lestrictiolm
Stli)SeqtiCllt woulid
lee(!ing
A!tliotigim
1iirimment
time of is
wount!
foi
and!
im-
coimfirmmmsnor of that in
negative /ine
as
acid
impressions (12)
Stiain im-
et
will
time
ill
answer
nucleic
aimd (Fig.
con
nonzinc-d!cficient
observations
I-i istologic
incisions
exanmi Imation
time
mel)t)rted
findings timat
zinc
not
of
ORiain
supplementation
et time
(lid! not
(13), al.
-1)
trol
of tensile meas-
aimd
pair-fed
in
rats of
(!id
increase i)ostoi)eriitive
Ct a!.
time
region
of
time aimimal
healing and
7-day ORiain
wounds.
time
zinc-deprived
I..Jlmlorttinately
Zinc
ui-e Their
comparable
and
postoperative. not
Wound
Healing
REFERENCES
519
tensile findings
strength are,
with ours
12
dlays (Fig.
zinc
therefore, 3).
entirely In
on
our dif-
J.
p.
Zinc.
lim:
Elements
New York:
in
studies
tensile
of
the
strength
effect we
of
deficiency
significant
of zinc defi-
Zim 1964.
requireacid
synthesis
deoxyribonucleic
by
between
I)aim-fed!
J. Biol.
H.
of zinc
239: R.
jim
wounds
were
after
not
12
sig-
3.
H.,
deficiency
-SND
RiN!uol. synthesis
Impairby
whereas thy
therefore,
deoxsriboimucleic
days
tensile
postoperative.
strength
time rat.
J. Cell
Piiysiol.
We,
of
P.
J.,
ANI)
J.
acids
M. iim 1969.
Hsu. ziimc
Oxidation deficient
of rats.
zinc-supplenmented
#{176}C-lab1ed hderation
5. .S-ssosiisn,
anmiimo
animals It a
se (men
days unlikely
that
i-I., SNO
C.
H. SIiEen.sRn.
teimsile jim time strength
Effect
(if of
int!ividual We
animals)
im-
of
/iimc
on time
iimcisioims
iimtcgunmeimt
that
demonstrate to
ind!ividuals
imzinc and 6.
Pioc. W.
Sac.
l!xtl. D.
om MORToN, Effect of
Thai.
\V.
Med.
128:
ANI)
687,
1968. MillER,
C. M. restrictc(l
healing
relatively
subsequent
zinc deficient
them-have
zinc in
J.,
J.
J.
Piirs
CiiFioN. feediimg
zinc
heahiilg
deficiency
in bovine.
and
wound
REICH,
dietary
(liet
Proc.
Soc.
Exptl. W.
Effect
itiol. N.,
of iron
It zinc that
may 7.
Pr-sso, Ss1SMvr.
iroim levels
M.
L. gut oim
/.
increased! d!ietary
situation.
in-
and
al)sorptiolm
crucial 8. FORBES,
M. in
Y0IIE.
Ziimc rat.
requirement 70:
balance E.
the E.
I. Niitr.
53,
SUM
MARY
9.
Ssviov,
of
J.
New
Dusiiiiv. Engi. 1. H.
sttidies wouimd New
Mecimanisms
wouimd
W.
Med. 250: B.
healing.
1062,
.&ND ac-
The tegument
tensile
rate
of
closure
of
d!efects
the in
inand de-are
10.
1954.
(stii-gical
strength of
or
healing
thermal)
wounds
the
STRAIN, C. H.
H.,
A. M.
Durrox, antI
HEY ER
oim the
RAMsEY. of
Experimental burim
celeratioim Rochester
11. Poirs, W. sulfate. H.
Univ.
1953.
ROB AND
creased!
by not
zinc improve
deficiency
in
the
i-at.
Rept.
\V.
STRAIN.
Rochester,
York, C. G.
healing
Zinc
will
tensile
supplementation
the
of strength wounds
of
rate
normal
of closure
rats
or
H.,
J.
H.
165:
HENJEL,
of 432, zinc 1967. sulfate
the 12.
13.
Acceleration
Surg.
witim
zinc
the in
integu-
Ann.
S. 1: 1069, S., Time
HUSAIN,
L.
iim
leg
ulcers.
ment.
The and Dr. suggestions. authors H. William tlmank Scott Dr. for \Villiam their
I.ancet
J.
ORi-ux, SIAN.
COPENHAGEN
AND
J.
the
S.
CAL-
Darby
zinc iim
sulphate rats.B,it.
on
healing
comnments
aimd of
21:
incised 240,
J.
Plastic
Surg.