English

Abstract

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. KEYWORDS Topical Heparin, Nebulised Heparin, Hospital Stay, Scar Outcome, Secondary Procedures, Pain