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A Systematic Literature Review

Ewan Alastair John Wilkinson, MBChB, MFPHM; Catherine Isobel Hawke, MBBS

Arch Dermatol. 1998;134:1556-1560.

Objective  To determine whether oral zinc sulfate is an effective treatment for promoting healing of venous or arterial leg ulcers.

Data Sources  The search strategy of the Cochrane Wounds Group was used. This includes searches of electronic databases, conference proceedings, relevant bibliographies, and hand searching of journals.

Study Selection  Studies were included if they were randomized controlled trials of oral zinc sulfate in the treatment of chronic venous or arterial ulcers with objective measures of healing. Six of the 10 studies initially identified were included in the review.

Data Extraction  The trial method, participants, interventions, outcomes, baseline comparability, adequate reporting of withdrawals, and blinding of assessment were extracted by 2 reviewers independently.

Data Synthesis  No trial showed a statistically significant benefit of zinc sulfate for healing leg ulcers. There is limited evidence to suggest that zinc might increase healing in individuals with a low serum zinc level, but more evidence is needed.

Conclusions  There is no evidence of benefit from the general use of zinc sulfate in patients with chronic leg ulcers. There is a need for further research to see if oral zinc sulfate is beneficial in the treatment of patients with leg ulcers who have a low serum zinc level. If it is demonstrated to be beneficial, further trials are required to establish dose and duration of treatment.

From the Department of Public Health, University of Oxford (Dr Wilkinson), and Oxfordshire Health Authority, (Dr Hawke), Oxford, England.

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