2022 Volume 2 Issue 1 Pages rev-1-rev-19
Zinc deficiency is associated with delayed bone healing, skin fragility, and susceptibility to infection due to immunodepression, therefore it has a significant impact on surgical outcomes. The author first became interested in the mechanism of bone healing in a case where an ankle fracture in a dialysis patient did not heal after three operations, and a zinc wave was later found in electron microscopy and electron probe X-ray microanalysis of frozen sections of the ossified area of the yellow ligament. Subsequently, shoulder injections to a rheumatoid arthritis patient caused pyogenic arthritis, suggesting that low zinc levels in rheumatoid arthritis patients resulted in weak skin and a low skin tenderness threshold. Later analysis showed that patients with zinc levels below 50 μg/dL died early due to infections, suggesting that low zinc levels are also related to poor immunity. Two groups were compared after 2 months and after 6 months of supplementation with 34 mg/day of zinc to examine how much zinc should be supplemented by the time of joint replacement surgery. There was no significant difference in zinc levels in the two groups at 1 month before surgery, but at 7 days before surgery and 3 days after surgery, in the first group zinc levels were significantly lower, skin necrosis occurred in three cases, and skin healing was delayed in four cases. If there is concern about the patient’s preoperative condition, it is recommended that zinc levels be measured and that adequate zinc supplementation be performed before surgery.
