Vitamin and Trace Element Loss from Negative-Pressure Wound Therapy

Area of Science:

• Biochemistry
• Clinical Nutrition
• Wound Care

Background:

• Negative-pressure wound therapy (NPWT) is widely used for complex wounds.
• Burn and trauma patients often present with significant nutritional deficits.
• Wound exudates can contain essential nutrients.

Purpose of the Study:

• To quantify the loss of select vitamins (A, C, E) and trace elements (zinc, iron, copper) in wound exudates of patients treated with NPWT.
• To compare micronutrient loss between patients with open abdomens and those with soft-tissue wounds.

Main Methods:

• Prospective observational study involving wound exudate sample collection.
• Analysis of exudates for vitamins A, C, E and trace elements zinc, iron, and copper.
• Calculation of daily micronutrient loss based on concentration and 24-hour exudate volume.

Main Results:

• Significantly higher exudate volume and micronutrient loss were observed in the open-abdomen group compared to the soft-tissue wound group.
• Mean 24-hour losses in open-abdomen patients included: 0.3 mg Vitamin A, 2.8 mg Vitamin C, 11 mg Vitamin E, 0.5 mg Zinc, 0.4 mg Iron, and 0.25 mg Copper.
• Micronutrient loss was significantly lower in patients with soft-tissue wounds.

Conclusions:

• Substantial amounts of essential micronutrients are lost via wound exudates in patients treated with NPWT.
• These losses are particularly pronounced in patients with open abdominal wounds.
• Nutritional support strategies for these patients must account for these significant micronutrient losses, especially given their hypermetabolic state.