Biochemical and immunological changes as prognostic factors after homografts application for the management of major burn patients

Abstract

Objectives To study the immunological and biochemical changes occurring after the application of homografts in the management of major burns and their implication as prognostic indices. Background Early excision of deep burn has been one of the critical advances in burn care. The advantages of early burn excision and closure is well established and it is generally accepted that it is a life-saving procedure. Patients and methods This study was done at the Plastic and Reconstructive Surgery Department, Menoufia University Hospitals as well as Al-Babtain Plastic Surgery and Burn Center in Kuwait. It was done from April 2016 to October 2018 on 15 patients with a follow- up period of more than 1 year in some cases. All patients were subjected to early excision of the burn eschar and then immediate coverage with either homografts, cadaveric grafts, or debridement only when grafts were not available. The changes in the laboratory parameters after 72 h postsurgery were compared with those 24 h before surgery to detect the effect of each technique on the clinical outcome. Results Three groups were investigated with the most significant fluctuation in the parameters measured in the first group of living donor homografts as compared with the second group cadaveric homograft and sole burn debridement as the third group. Conclusion The immunological parameters and inflammatory cytokines were improved by the use of homografts; detecting these changes in burned patients can anticipate whether the course of treatment is favorable or not.