Zinc Research For Wound Healing

Zinc is important for wound healing

There are a lot of claims for zinc in the context of wound healing. These study summaries are hopefully unbiased. Different medical groups have different opinions. A lot of doctors and dietitians say unless there is a deficiency do not worry about tablets. Just eat good food. Integrative practitioners and naturopaths are more likely to say yes it is worth supplementing. However zinc oxide is to be avoided and to use zinc gluconate or sulfate. I have seen positive changes in wound healing and also no obvious observable benefit. All are individual and someone with no deficiency may have subclinical deficiency.

Zinc creams on the local area surround ing the wound has a more positive observable change.

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Visit NIH for more information on zinc

Zinc is needed for :

growth and development
healing bone metabolism
central nervous system
immune function
needed in the human genome.

Zinc is absorbed in the small intestine.
Illnesses, infection high phylate containing foods slows down the uptake of zinc.
Most of the zinc is stored in muscle in bones sticking to the liver and other organs. Therefore zinc deficiency affects these organs.
A zinc deficiency is common especially with malnutrtion.. Zinc deficiency can cause absorption syndromes, renal disease, liver disease, dermatitis, mental and growth problems, ageing, immune dysfunction, and slow wound healing.
Skin contains 5% of zinc body content. Mild skin deficiency can lead to roughened skin and impaired wound healing.
Zinc levels may need to be increased in burns, abscesses, minor surgery, pressure ulcers and critically ill patients.

Serum Zinc Concentrations in the US Population Are Related to Sex, Age, and Time of Blood Draw but Not Dietary or Supplemental Zinc

Wound healing and immune system work together. Zinc can help with the adaptive and innate immune system.
There are 4 phases of wound healing. Below is where zinc is needed in each of these phases.

Blood Clotting after injury
Zinc helps the platelets to form the initial clot after an injury and starts the inflammatory phase of healing
Inflammation and Immune defence
Inflammation is a good thing, until it’s not!
Immune cells are able to come to the injured tissue and get rid of cell debris and infection, microbes

A study with 55-85 yr old with mild zinc deficiency had increased inflammation and oxidative stress.
When they took zinc, things improved-less abnormal inflammation.
Zinc also helps cells called neutrophils to gobble up the bad guys, but too much zinc does the opposite.
Zinc can help or hinder M1/M2 macrophage clearance. Macrophages clear microbes and damaged tissue.
Macrophages can deprive bacteria of zinc or poison bacteria with too much zinc and other heavy metals. That’s a good thing.
B-Lymphocytes aid in wound repair and clearance. Mature B-cells, plasma cells, detect damage in tissue by making antibodies and signal macrophages to eat damaged cells. Zinc deficiency causes fewer cells to be eaten and cleared.
In slow healing diabetic mice skin lesions, direct B-cell treatment hastens wound healing.

Inflammatory resolution and tissue growth stage
Once the wound has clotted and the immune call have come and eaten the baddies and cleared dead cells, now it’s time to rebuild and close the wound with new skin.
Regulatory T lymphocytes regulate and suppress inflammation. Zinc supplementation increase TREGS
TREGS stop inflammation and promote skin cells to grow and wound to contract.
Two or 3 days after the wound occurs, fibroblasts enter the wound site and this is the tissue growth stage. Fibroblasts help collagen to be put down in the wound and acts as a bed for other cells to move over. Zinc is needed for this.
Wound resolution and remodelling
MMP’s are protein secretes by inflammatory cells, keratinocytes, endothelial cells and fibroblasts. Zinc is needed to make MMPs.

Research Studies:
If there is a zinc deficiency or burns, it is worth supplementing.

There was a study where patients were given a high calorie protein drink with arginine, anti oxidants and zinc (18-20mg), either by tube or oral. It is unknown what role zinc played in this study. In this study zinc is in conclusive.
A meta analysis of topical zinc therapy with zinc oxide (ZnO) paste dressing for chronic venous ulcers showed improved healing.

In the end studies show both ways, this also depends on the cohort and study design.

Some people take zinc or use the paste and swear by it, others there is no difference.

Zinc is better taken not in an oxide form.

Zinc cream at 3% is widely used in wound healing as an anti oxidant.
Recently there has been advances with zinc oxide nanotechnology, but more studies are needed.

Citations
Lin PH, Sermersheim M, Li H, Lee PHU, Steinberg SM, Ma J. Zinc in Wound Healing Modulation. Nutrients. 2017 Dec 24;10(1):16. doi: 10.3390/nu10010016. PMID: 29295546; PMCID: PMC5793244.

Saeg F, Orazi R, Bowers GM, Janis JE. Evidence-Based Nutritional Interventions in Wound Care. Plast Reconstr Surg. 2021 Jul 1;148(1):226-238. doi: 10.1097/PRS.0000000000008061. PMID: 34181622.

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