Burn Treatment in Brazil with Heparin

Dr. Costa:

Admits and treats 240 burned patients a year, of which 40% are children.
Over 2200 patients, age 10 days to 93 years, have been treated with heparin administered topically 4-5 times a day until healed, intravenously initially once a day, and then subcutaneously.
Dr. Costa lists benefits of using heparin are improved care, relieved pain without morphine, reduced procedures, reduced mortality, larger size burns can be treated cost-effectively - costs are reduced up to 70%.
The necessity to change dressings was reduced and then abolished. Water baths and debridements were not needed. The burns turned dryer, and smaller. Burned tissue flaked off after the fifth day, because the wound was healing under burn crusts, especially with 2nd degree burns. At the 7th Day, the 3rd degree burns were debrided and grafted, reducing the time of hospitalization.
"Heparin treatment brings (returns) quality of life to our burned patients!”
Dr. Costa presented studies at:
- SBI sponsored Int’l Heparin Symposium in Las Vegas Nevada, USA in March 2000,
- 6th Int’l Heparin Symposium in the 5th Asian Pacific Burn Congress in Shanghai, in 2004 and
- 7th Int’l Heparin Symposium in the 13th ISBI Congress in Fortaleza Brazil, September 2006.
Summary of 2 Studies with Controls:
(1) 20 patients treated with heparin (H) were compared to 20 Control (C) cohort patients not treated with heparin; and
(2) Another study of 20 H patients were compared with 22 C patients given Traditional Care without Heparin. Patients with a contraindication to heparin, or with diabetes, epilepsy, and/or alcoholism, were excluded. Treated H patients received heparin intravenously for the first 48 hours, subcutaneously twice a day for 3 days, and topically 3-4 daily from onset into final healing. Results. Control patients (C) without heparin required pain medicine every 4 hours. Heparin treated (H) needed none. Inflammation abated in H, persisted in C. In H, a total 5 anesthetics and operations in 20pts, av 0.2/pt, were significantly less compared to C (100% of C had 2.5 av ops/ pt). Baths with removal of burned tissue (debridements) were discontinued in H, but needed and used in C. In H, Blood Transfusions, 4 total in 20pts ( 20%) of 390 ml average per transfusion, were significantly less than in C, 13 in 22pts (59.9%), of 1,642 ml of blood/pt av. Days in Hospital was 16.5 av in H, and 21 Days av in C. The postburn days to reepithelialize the burns (new skin) was 16.5 day in H, and 21 days in C. The new skin in H was remarkably smoother with less contracture and less scar. The cost in H was 70% less than C. All of these improvements resulted in a sense of well-being in patients, especially children and their mother.