Large Burns in Humans

Abstract

Seven patients with deep second- and third-degree burns covering 15%, 31%, 34%, 40%, 47%, 51%, and 60% of their bodies were treated with large doses of heparin sodium administered parenterally and topically. Heparin relieved the pain and prevented burn extension so that the initial burn size was the maximum eventual size. No edema, symptoms of toxic reactions, or shock developed. Compared to Brooks' formula or Evans' formula, fluid therapy requirements were significantly less (P<.001). No escharotomy or fasciectomy was required during heparin treatment; one fasciectomy was done later. There was enhanced revascularization, granulation, and re-epithelialization without contracture, infection, or graft. No bleeding problems occurred. No respiratory problems occurred during treatment. One case of pneumonitis occurred later. One death from gram-negative septicemia occurred 35 days after heparin therapy was terminated. The effect of heparin was dose-related and dose-dependent.