043 Effects of Early Wound Excision on Hepatic Blood in the Extensively Burned Rat

Abstract

Aim: Effects of early excision on hepatic blood flow were investigated in burned rats. Methods: 30% TBSA burned Wistar rats were allocated to four groups, infusion group (n = 13): fluid resuscitation with lactated Ringer’s; early excision group (n = 13): early escherectomy and allogenic skin grafting with fluid resuscitation; burn group (n = 13): burn injury alone without any treatment; sham group (n = 15): sham burn procedure. The hepatic blood flow was measured at 0, 0.5, 1, 2, 3, 6, 12 and 24 hours postburn. At 12 and 24 hours postburn, plasma Endothelin‐1 (ET‐1) and nitric oxide (NO) levels were detected. Results: In the infusion and the burn group, a significant decrease in hepatic blood flow compared with the sham group. In contrast in the early excision group, the hepatic blood flow was not decreased and there was a significant difference from the infusion group at 12 hours postburn. The plasma ET‐1 and NO levels were markedly elevated in the infusion and the burn group at 12 and 24 hours postburn. Whereas in the early excision group, no significant increase either in the plasma ET‐1 or NO levels were found compared with the sham group during experimental period. Conclusion: The hepatic blood flow decreases after a massive burn injury even with adequate fluid resuscitation. Early excision is helpful in stabilizing the hepatic blood flow without further aggravating the hepatic hemodynamic load. The decrease in plasma ET‐1 and NO levels after early wound excision procedure may be playing a role in improving the hepatic blood flow.