Topical Clinical Use of Heparin in Acute Second Degree Burns
S.J. Oh, J.W. Lee, Y.C. Chang.
Plastic & Reconstructive Surgery, Hallym Burn Center, Hangang Sacred Heart Hospital, Seoul, Korea
Aims: Heparin therapy through topical or systemic application in acute burn wound has been reported in the previous literatures to improve pain relief and also reduce healing time and scar formation of burn wound. In our study we report preliminary evaluation of topical heparin effect in acute second degree burns related to sites of burns, depth of burn injury, healing time, operation rate and degree of scaring
Material and Methods: Ourclinical data collected 369 patients during last 9 months. In sex distribution male was 215, female 154. The children were the most common (143 patients). The multiple sites of burns were the most common (217 patients). Deep second-degree burns were the most common (267 patients). We apply daily over three times of topical application of heparin on the burned wound combined with closed or open dressing. Skin grafting was performed in some patients because of worry about scar formation around 10th or 14th burned day. We observe the appearance of healing wound during Out Patient Department follow-up.
Results: 99 patients (26.8%) among 369 patients were performed skin grafting during heparin therapy. Skin grafting was decided frequently in burns of extremity more than head and neck. 270 patients were treated their burns with topical heparin application. Hypertrophic scaring after healing of wound was developed frequently in extremity more than head and neck. But 89 patients (52.7%) among the second degree deep burns (169 patients) showed acceptable appearance after healing of wound.
Conclusion: This studydemonstrated that topical heparin therapy of the acute second-degree burns especially in the trunk; head and neck area is effective. But deep second degree burns after complete healing over three weeks can be developed hypertrophic scaring. We recommend that the second-degree deep burns should be considered skin grafting in extremity during topical heparin therapy.
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