Srikanth Reddy Challapalli1, Venkata Prakash Gandikota2, Archana Chilakala3, Yaswanth Kumar Gaddam4
BACKGROUND
Burn treatment is complex and involves many components. Topical solutions that
contain antiseptic, antibiotic, and growth factor properties are effectively used in
superficial burns. Heparin satisfies all the parameters. Routes of heparin
administration described are subcutaneous, topical, intravenous, and inhalation.
In this study, the need was felt to evaluate the efficacy of various heparin routes
such as topical against nebulised heparin.
METHODS
100 consecutive thermal burn patients were studied prospectively under two
groups i.e., topical heparin (T group) and nebulised heparin (N group). Hospital
stay, final scar outcome, wound infection rate, secondary procedures, pain
medication, dressings and antibiotics required were compared.
RESULTS
It was found that the T patients complained of less pain and received less pain
medication, fewer dressings and antibiotics compared to N group. Significantly less
IV fluids were infused to T group 36 vs 64 litres compared to N group (P < 0.01).
T group had fewer secondary procedures 6 vs 14 compared to N group. The
number of days in hospital for T was significantly less (over all P < 0.0001). 14
patients (28 %) in the topical group were discharged from the hospital in 10 days
or less compared with 8 patients (16 %) in the nebulised group (P < 0.001, S). 38
out of the 50 H patients (76 %) were discharged in less than 3 weeks compared
with 22 nebulised group patients (32 %) (P < 0.001, S).
CONCLUSIONS
Usage of Heparin is safe, needs no monitoring by bleeding time (BT), clotting time
(CT), or partial thromboplastin time (PTT). The final scar outcome with parameters
such as scar itchiness, texture, the wound infection rate, secondary procedures
like a skin graft, post-burn contractures release were fewer in burn patients treated
with topical heparin.
