WORLD JOURNAL OF PLASTIC SURGERY
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Volume 10, Issue 2 (2021)
WJPS 2021, 10(2): 40-45 |
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Ojo A B, Oluwatosin O M, Ademola S A, Akinosun O M. Plasma Zinc Levels in Patients with Chronic Leg Ulcers at University College Hospital, Ibadan, Nigeria. WJPS 2021; 10 (2) :40-45
URL: http://wjps.ir/article-1-782-en.html
URL: http://wjps.ir/article-1-782-en.html
Adedoyin Babatunde Ojo * 
1, Odunayo Moronfoluwa Oluwatosin2 , Samuel Adesina Ademola2 , Olubayo Michael Akinosun3
1, Odunayo Moronfoluwa Oluwatosin2 , Samuel Adesina Ademola2 , Olubayo Michael Akinosun3
1- Department of Surgery, University College Hospital, Ibadan, Nigeria
2- Department of Surgery, College of Medicine, University of Ibadan, Nigeria
3- Department of Chemical Pathology, University College Hospital, Ibadan, Nigeria
2- Department of Surgery, College of Medicine, University of Ibadan, Nigeria
3- Department of Chemical Pathology, University College Hospital, Ibadan, Nigeria
Abstract: (2339 Views)
BACKGROUND
Chronic leg ulcers are defects in the skin below the level of knee persisting for more than six weeks and shows no tendency to heal after three or more months. Zinc is a necessary component of several DNA & RNA polymerases and transferases essential for cell proliferation. Zinc deficiency is known to
retard wound healing by preventing cellular mitosis and disturbance of fibroblast function and collagen synthesis. This study compares zinc levels in patients with chronic leg ulcers with apparently healthy individuals.
METHODS
Five milliliters of venous blood samples was taken from twelve patients with chronic leg ulcers. Five milliliters of venous blood samples was also taken from a control group, who do not have chronic leg ulcers, but are matched with the cases in age (± 5 yr), sex, socioeconomic status and body mass index
(± 3 kg/m2). Plasma zinc levels was determined by atomic absorption spectrophotometry. Principal exposure include the socio-demographic characteristics of patients, duration of symptoms before presentation, signs of ulcer–site, number, size, depth, base, edge, presence of discharge, enlarged lymph nodesand local neurovascular integrity. The outcome variables include plasma levels of biochemical markers measured –Zinc, serum albumin, total protein.
RESULTS
The plasma zinc levels was significantly lower (P<0.01) in patients with chronic leg ulcer (92.808±16.689 μg/dl) as compared with control subjects (109.413 ± 9.304 μg/dl). There was no statistical differrence in albumin and protein levels in both groups.
CONCLUSION
Patients with chronic leg ulcers have significantly lower plasma zinc levels than apparently healthy individuals.
Chronic leg ulcers are defects in the skin below the level of knee persisting for more than six weeks and shows no tendency to heal after three or more months. Zinc is a necessary component of several DNA & RNA polymerases and transferases essential for cell proliferation. Zinc deficiency is known to
retard wound healing by preventing cellular mitosis and disturbance of fibroblast function and collagen synthesis. This study compares zinc levels in patients with chronic leg ulcers with apparently healthy individuals.
METHODS
Five milliliters of venous blood samples was taken from twelve patients with chronic leg ulcers. Five milliliters of venous blood samples was also taken from a control group, who do not have chronic leg ulcers, but are matched with the cases in age (± 5 yr), sex, socioeconomic status and body mass index
(± 3 kg/m2). Plasma zinc levels was determined by atomic absorption spectrophotometry. Principal exposure include the socio-demographic characteristics of patients, duration of symptoms before presentation, signs of ulcer–site, number, size, depth, base, edge, presence of discharge, enlarged lymph nodesand local neurovascular integrity. The outcome variables include plasma levels of biochemical markers measured –Zinc, serum albumin, total protein.
RESULTS
The plasma zinc levels was significantly lower (P<0.01) in patients with chronic leg ulcer (92.808±16.689 μg/dl) as compared with control subjects (109.413 ± 9.304 μg/dl). There was no statistical differrence in albumin and protein levels in both groups.
CONCLUSION
Patients with chronic leg ulcers have significantly lower plasma zinc levels than apparently healthy individuals.
References
1. Mork F 2009 Cutaneous ulcers, sinuses and fistulae In Badoe EA, Archampong EQ, da Rocha-Afodu JT editors Principles and Practice of Surgery Including Pathology in the Tropics Fourth Edition Accra: Assemblies of God Literature Centre Ltd:70-82.
2. Barbul A, Efron TD, Kavalukas SL 2015 Wound healing In Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE editors Schwartz's Principles of Surgery Tenth Edition New York NY: McGrawhill:241-72.
3. Burnand K 2008 Venous disorders In Williams NS, Bulstrode CJK, O'Connell PR editors Bailey & Love's Short Practice of Surgery 25th Edition London: Hodder Arnold:925-43.
4. Baker SR, Stacey MC, Jopp-Mckay AG, Hoskin SE, Thompson PJ 1991 Epidemiology of chronic venous ulcers. Br J Surg 78(7):864-7.
5. Sarkar PK, Ballantyne S 2000 Management of leg ulcers Postgrad Med J 76(901):674-682.
6. Moloney M.C, Grace P 2004 Understanding the underlying causes of chronic leg ulceration J Wound Care 13(6):215-218.
7. Newton H 2011 Leg ulcers: differences between venous and arterial Wounds Essentials 6(1):20-28.
8. Saharay M, Shields DA, Porter JB, Scurr JH, Smith PDC 1997 Leucocyte activity in the microcirculation of the leg in patients with chronic venous disease J Vasc Surg 26(2):265-273.
9. Irving G, Hargreaves S 2009 Venous and arterial leg ulceration InnovAiT 2:415-422.
10. Archampong EQ 2009 Wounds and wound healing In Badoe EA, Archampong EQ, da Rocha-Afodu JT editors Principles and Practice of Surgery Including Pathology in the Tropics Fourth Edition Accra: Assemblies of God Literature Centre Ltd:57-69.
11. Pohit J 1981 A zinc tolerance test Clin. Chim. Acta 114:279.
12. Chooi MK, Todd JK, Boyd ND 1976 Influence of age and sex on plasma zinc levels in normal and diabetic individuals Nutrition and Metabolism 20(2): 135-142.
13. Buxaderas SC, Farre-Rovira 1985 Whole blood and serum zinc levels in relation to sex and age Revista Espanola de Fisiologia 41(4): 463-470.
14. Bhatt A, Farooq MU, Enduri S, Pillainayagam C, Naravetla B, Razak A, Safdar A, Hussain S, Kassab M, Majid A 2010 Clinical significance of serum zinc levels in cerebral ischemia Stroke Res Treat 245715.
15. Wright M 2014 Zinc deficiency, excess and supplementation Dermatology
16. Grant GH, Silverman LM, Christenson RH 1987 Amino acids and proteins Fundamentals of Clinical Chemistry 3rd edition 328-30.
17. Scholl D, Langkamp-Henken B 2001 Nutrient recommendations for wound healing J Intraven Nurs 24(2):124-32.
18. Lansdown ABG, Mirastschijski U, Stubbs N, Scanlon E, Agren MS 2007 Zinc in wound healing: Theoretical, experimental, and clinical aspects Wound Repair Regen 15(1):2-16
19. Oldewage-Theron WH, Samuel FO, Venter CS 2008 Zinc deficiency among the elderly attending a care centre in Sharpeville, South Africa J Hum Nutr Diet Dec;21(6):566-74.
20. Olaniyan OO, Awonuga MAM, Ajetunmobi AF, Adeleke IA, Fagbolade OJ, Olabiyi KO, Oyekanmi BA, Osadolor HB 2012 Serum copper and zinc levels in Nigerian type 2 diabetic patients AJDM Nov;20(2):36-39.
21. Iyun AO, Ademola SA, Olawoye OA, Michael AI, Oluwatosin OM 2016 Point prevalence of chronic wounds at a tertiary hospital in Nigeria Wounds 28(2):57-62.
22. Rojas AI, Phillips TJ 1999 Patients with chronic leg ulcers show diminished levels of Vitamins A and E, Carotenes and Zinc Dermatol Surg 25(8): 601-4.
23. Minniti CP, Hildesheim M, Sachdev V, Allen D, Castro O, Taylor VI JG, Kato GJ 2009 Sickle cell leg ulcers are associated with hyperuricemia, hemolysis, pulmonary hypertension and death Blood 114:2583.
24. Amir O, Liu A, Chang ALS 2012 Stratification of highest-risk patients with chronic skin ulcers in a Stanford retrospective cohort includes Diabetes, need for systemic antibiotics, and albumin levels Ulcers 2012:767861.
25. Kumera G, Awoke T, Melese T, Eshetie S, Mekuria G, Mekonnen F, Ewunetu T, Gedle D 2015 Prevalence of zinc deficiency and its association with dietary, serum albumin and intestinal parasitic infection among pregnant women attending antenatal care at the University of Gondar Hospital, Gondar, Northwest Ethiopia BMC Nutrition 1:31.
26. Parizadeh SMR, Kazemi-Bajestani SMR, Shapouri-Moghaddam A, Ghayour-Mobarhan M, Esmaeili H, Majdi MR, Emadzadeh A, Safarian M, Azimi-Nezhad M, Khodael GH, Hosseini SJ, Parizadeh SMJ, Oladi MR, Ferns G 2011 Serum zinc and copper concentrations and socio-economic status in a large Persian cohort Asian Biomed 5(3):329-35.
27. Mork F 2009 Cutaneous ulcers, sinuses and fistulae In Badoe EA, Archampong EQ, da Rocha-Afodu JT editors Principles and Practice of Surgery Including Pathology in the Tropics Fourth Edition Accra: Assemblies of God Literature Centre Ltd:70-82.
28. Barbul A, Efron TD, Kavalukas SL 2015 Wound healing In Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE editors Schwartz's Principles of Surgery Tenth Edition New York NY: McGrawhill:241-72.
29. Burnand K 2008 Venous disorders In Williams NS, Bulstrode CJK, O'Connell PR editors Bailey & Love's Short Practice of Surgery 25th Edition London: Hodder Arnold:925-43.
30. Baker SR, Stacey MC, Jopp-Mckay AG, Hoskin SE, Thompson PJ 1991 Epidemiology of chronic venous ulcers. Br J Surg 78(7):864-7.
31. Sarkar PK, Ballantyne S 2000 Management of leg ulcers Postgrad Med J 76(901):674-682.
32. Moloney M.C, Grace P 2004 Understanding the underlying causes of chronic leg ulceration J Wound Care 13(6):215-218.
33. Newton H 2011 Leg ulcers: differences between venous and arterial Wounds Essentials 6(1):20-28.
34. Saharay M, Shields DA, Porter JB, Scurr JH, Smith PDC 1997 Leucocyte activity in the microcirculation of the leg in patients with chronic venous disease J Vasc Surg 26(2):265-273.
35. Irving G, Hargreaves S 2009 Venous and arterial leg ulceration InnovAiT 2:415-422.
36. Archampong EQ 2009 Wounds and wound healing In Badoe EA, Archampong EQ, da Rocha-Afodu JT editors Principles and Practice of Surgery Including Pathology in the Tropics Fourth Edition Accra: Assemblies of God Literature Centre Ltd:57-69.
37. Pohit J 1981 A zinc tolerance test Clin. Chim. Acta 114:279.
38. Chooi MK, Todd JK, Boyd ND 1976 Influence of age and sex on plasma zinc levels in normal and diabetic individuals Nutrition and Metabolism 20(2): 135-142.
39. Buxaderas SC, Farre-Rovira 1985 Whole blood and serum zinc levels in relation to sex and age Revista Espanola de Fisiologia 41(4): 463-470.
40. Bhatt A, Farooq MU, Enduri S, Pillainayagam C, Naravetla B, Razak A, Safdar A, Hussain S, Kassab M, Majid A 2010 Clinical significance of serum zinc levels in cerebral ischemia Stroke Res Treat 245715.
41. Wright M 2014 Zinc deficiency, excess and supplementation Dermatology
42. Grant GH, Silverman LM, Christenson RH 1987 Amino acids and proteins Fundamentals of Clinical Chemistry 3rd edition 328-30.
43. Scholl D, Langkamp-Henken B 2001 Nutrient recommendations for wound healing J Intraven Nurs 24(2):124-32.
44. Lansdown ABG, Mirastschijski U, Stubbs N, Scanlon E, Agren MS 2007 Zinc in wound healing: Theoretical, experimental, and clinical aspects Wound Repair Regen 15(1):2-16
45. Oldewage-Theron WH, Samuel FO, Venter CS 2008 Zinc deficiency among the elderly attending a care centre in Sharpeville, South Africa J Hum Nutr Diet Dec;21(6):566-74.
46. Olaniyan OO, Awonuga MAM, Ajetunmobi AF, Adeleke IA, Fagbolade OJ, Olabiyi KO, Oyekanmi BA, Osadolor HB 2012 Serum copper and zinc levels in Nigerian type 2 diabetic patients AJDM Nov;20(2):36-39.
47. Iyun AO, Ademola SA, Olawoye OA, Michael AI, Oluwatosin OM 2016 Point prevalence of chronic wounds at a tertiary hospital in Nigeria Wounds 28(2):57-62.
48. Rojas AI, Phillips TJ 1999 Patients with chronic leg ulcers show diminished levels of Vitamins A and E, Carotenes and Zinc Dermatol Surg 25(8): 601-4.
49. Minniti CP, Hildesheim M, Sachdev V, Allen D, Castro O, Taylor VI JG, Kato GJ 2009 Sickle cell leg ulcers are associated with hyperuricemia, hemolysis, pulmonary hypertension and death Blood 114:2583.
50. Amir O, Liu A, Chang ALS 2012 Stratification of highest-risk patients with chronic skin ulcers in a Stanford retrospective cohort includes Diabetes, need for systemic antibiotics, and albumin levels Ulcers 2012:767861.
51. Kumera G, Awoke T, Melese T, Eshetie S, Mekuria G, Mekonnen F, Ewunetu T, Gedle D 2015 Prevalence of zinc deficiency and its association with dietary, serum albumin and intestinal parasitic infection among pregnant women attending antenatal care at the University of Gondar Hospital, Gondar, Northwest Ethiopia BMC Nutrition 1:31.
52. Parizadeh SMR, Kazemi-Bajestani SMR, Shapouri-Moghaddam A, Ghayour-Mobarhan M, Esmaeili H, Majdi MR, Emadzadeh A, Safarian M, Azimi-Nezhad M, Khodael GH, Hosseini SJ, Parizadeh SMJ, Oladi MR, Ferns G 2011 Serum zinc and copper concentrations and socio-economic status in a large Persian cohort Asian Biomed 5(3):329-35.
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