Vitamin D may improve wound healing in burns patients

Giving severe burns patients vitamin D supplements could be a simple and cost-effective way of helping their wounds to heal and avoiding infection.

This was the conclusion of the first study to examine the effects of vitamin D in burn injury recovery.

The research — which was led by the Institute of Inflammation and Aging in Birmingham, United Kingdom — is to feature at the Society for Endocrinology annual conference, held in Harrogate, U.K.

Burns are wounds to the skin and other tissues that are caused by heat — including exposure to a flame or fire, or from scalding. They can also result from friction, radiation, radioactivity, electricity, and contact with chemicals.

Burn injuries are considered a global public health problem and are responsible for around 180,000 deaths every year.

The majority of burns occur in the home or in the workplace. Worldwide, nonfatal burns are a leading cause of hospitalization, disfigurement, and disability.

Of the 486,000 people treated for burns every year in the United States, around 40,000 are hospitalized.

A high proportion of burn injuries occur in children. In the U.S., the direct cost of treating children with burns came to more than $211 million in 2000.

Vitamin D has antibacterial properties

However, despite advances in the treatment of burn injuries over the past decade, there are still many patients that do not make a good recovery.

For some people, their burn injuries take a long time to heal, as well as there also being a risk of infection. Those with severe burns are particularly vulnerable to sepsis, which is a potentially life-threatening condition triggered by infection.

There is increasing evidence that vitamin D has antibacterial properties and can fight infection. 

For example, it is known that vitamin D can increase antibacterial proteins "and enhance the environment in which they function," which together with other actions, promotes "increased bacterial killing in a variety of cell types."

The team responsible for the new study notes that low vitamin D is often linked to higher rates of death in people who are critically ill. And yet, little is known about the effect that vitamin D might have in burn patients.

Thus, for the study, the researchers measured progress of recovery of severe burns patients over 12 months and compared it with their vitamin D levels. Altogether, the study included 38 people with a 42 percent median total body surface area affected by burns.

Severe burns dramatically reduce vitamin D

The results showed that in general, compared with healthy people, the burns patients had lower levels of vitamin D.

In addition, burns patients with higher levels of vitamin D fared better than those with lower levels. For example, their wounds healed better, they experienced fewer complications, and they had less wound scarring.

The team says that the findings suggest that giving burns patients vitamin D supplements as soon as possible after injury could improve wound healing and help to prevent infection.

"Major burn injury severely reduces vitamin D levels," explains senior investigator Janet Lord, a professor at the Institute of Inflammation and Aging.

She also suggests that "adding this vitamin back may be a simple, safe, and cost-effective way to improve outcomes for burns patients, with minimal cost to [the] NHS [National Health Service]." 

The effectiveness of giving burns patients vitamin D supplements now needs to be tested in trials before such a treatment can be recommended.

"Low vitamin D levels were associated with worse outcomes in burn patients including life-threatening infections, mortality, and delayed wound healing. It was also associated with worse scarring but vitamin D levels are something generally overlooked by clinicians."

Prof. Janet Lord

In the meantime, the researchers are trying to discover why burns patients experience a rapid drop in vitamin D levels immediately following injury.

In the study, they found that the size of the reduction was not related to burn severity, suggesting that vitamin D may also fall rapidly in patients with less severe burns.