Article
appeared in Burns 27 (2001) 349-358
Abstract
Burns are difficult to treat, wounds with
complex local and systemic pathology and high mortality, that often
heal slowly with scars and contractures. Glycosaminoglycans
(GAGs) have been used in parenteral and topical application studies. These
studies have uncovered anticoagulative, antiinflammtory and neoangiogenic
properties, which may stimulate tissue repair and reepithelializing effects.
The endogenous GAGs utilized in treating burns are heparin, dermatan sulfate,
haparan sulfate, keratin sulfate, chondroitin-4- and chondroitin-6-sulfate,
and hyaluronic acid. Heparin, the most sulfated and acidic GAG, has been
used parenterally, topically, by inhalation, in pellet, and in bioengineered
membranes. Heparin relieved pain, inhibited clotting and inflammation, restored
blood flow, and enhanced healing. Heparin effects that improved and reduced
burn care were time, dose, pH, site, source and duration related in studies.
Potential adverse effects with heparin use are bleeding, thrombocytopenia
and allergy. Heparin preserved lung and improved function. Heparin preserved
intestinal integrity and reduced bacterial translocation. Collagen restoration
was enhanced. The healed skin was smooth. Heparin reduced needs for pain
medicine, topical antibiotics, resuscitation fluids, blood, water baths,
debridement, surgery and grafts. Costs of treatments were reduced. Although
not as yet fully substantiated, topical heparin therapy of burns may be a
useful addition to the range of available treatments for burn wounds.
© 2001
Elsevier Science Ltd. And ISBI. All rights reserved.
Keywords: Heparin; Treatment of burns; Review
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Correspondence:
Michael J. Saliba, Jr.
5582 Thunderbird Lane
La Jolla CA 93037 USA
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