Burns represent a major health problem world wide, with high mortality and morbidity, in addition to changes in quality of life of burned patients. The area of research in burn management is in continuous and dramatic increase utilizing new therapeutic strategies depending on new mechanisms involved in the pathogenecity of burn; increased free radical generation and decreased natural antioxidant "Oxidative stress" represent an important goal for targeting and new therapeutic strategy in the management of burn to decrease mortality and morbidity and improve burn outcome in general – the primary aim of treatment process - .
Patients and Methods: This study was carried out on 180 burned patients with age range 20 – 45 years (mean ± SD, 32 ±6.5), with both sexes (73 males and 107 females), different occupation, and varying burn percentage (15 – 40%) of total body surface area; they were admitted to the burn unit in Baquba General Hospital over a period of nine months. Patients allocated into 6 groups: A, B, C, D, E, and F, each group include 30 patients. Group A, treated according to hospital policy without antioxidant, while other groups B, C, D, E, and F treated with antioxidants; vitamin E with vitamin C, zinc sulphate, allopurinol, melatonin, and N-acetylcysteine respectively; in addition to other classical treatment recommended by hospital policy. In addition to that, 30 healthy subjects with age matched group (group G) were involved in the study as control group for comparison. To each group, serum MDA and serum GSH levels, serum zinc and copper levels, liver enzymes activity, blood urea, serum creatinine, and microalbuminuria, microbiological study, mortality rate, and healing time studies were done depending on standard methods. Results: Administration of antioxidants to burned patients in addition to other drugs administered according to classical method of hospital policy significantly reduce serum MDA level, and increase serum GSH level, increased serum zinc level and improve Cu/Zn ratio, protect organs from damage by free radicals as represented by improvement in liver enzymes activity, blood urea, and serum creatinine; in addition to that, antioxidant improve endothelial dysfunction as indicated by reduction in microalbuminuria, also treatment with antioxidants have a reducing effect on incidence of infection, and reduce mortality rate and healing time as compared to group A, where no antioxidant was given. Conclusion: Treatment of burned patients with antioxidants in addition to classical treatment exert an improving effect on oxidative stress parameters, serum zinc level and Cu/Zn ratio, incidence of infection, mortality rate and healing time in a safe way as shown by improvement in liver and renal function tests; in addition to that, this study clearly showed the importance of therapeutic targeting of oxidative stress in the treatment of burn. Moreover, this study considering antioxidant as one of the most effective weapons that must be added to the arsenal of weapons in combating morbidity and mortality in burned patients.