Post-burn Treatment Research Articles

Fire effects on plant communities in Ozark woodlands and glades

BackgroundDecades of fire suppression caused drastic changes to community structure and composition across ecosystems, including in Ozark woodlands in Missouri, USA. Reintroducing fire can restore ground flora by reducing midstory tree density, increasing ground layer light, and reducing leaf litter accumulation, but we lack a clear understanding of how these effects vary across time and space. We investigated the effects of repeated prescribed fire on ground flora species richness, floristic quality, abundance, community composition, and stand structure over 20 years in a landscape matrix of dry-mesic woodlands, dry woodlands, and glades using data collected from the Ozark National Scenic Riverways Fire Effects Monitoring program in the Current River Watershed in the Missouri Ozarks.ResultsWe found that fire plays a key role in driving community structure and dynamics across community types, although with varying levels of intensity. Herbaceous species richness, abundance, and floristic quality index increased across all community types, while mean coefficient of conservatism decreased. Abundance and floristic quality effects were stronger in drier sites. Community composition changed with successive burns, resulting in several indicator species for post burn treatments. The density of midstory trees declined across community types with repeated fire. The number of burns significantly affected overstory tree density overall, but overstory tree density only declined in dry woodlands and glades and not in dry-mesic woodlands.ConclusionsOur results suggest that landscape fire shapes plant community structure and dynamics. Specifically, these findings show that fire effects vary among community types and suggest that land managers should consider landscape heterogeneity in fire application for restoration. Separate community types imbedded in the same landscape may respond to fire differently. Understanding repeated fire effects over several decades across multiple community types is critical to informing fire-driven woodland restoration across landscape scales.

The role and therapeutic potential of gut microbiome in severe burn.

Severe burn is a serious acute trauma that can lead to significant complications such as sepsis, multiple organ failure, and high mortality worldwide. The gut microbiome, the largest microbial reservoir in the human body, plays a significant role in this pathogenic process. Intestinal dysbiosis and disruption of the intestinal mucosal barrier are common after severe burn, leading to bacterial translocation to the bloodstream and other organs of the body, which is associated with many subsequent severe complications. The progression of some intestinal diseases can be improved by modulating the composition of gut microbiota and the levels of its metabolites, which also provides a promising direction for post-burn treatment. In this article, we summarised the studies describing changes in the gut microbiome after severe burn, as well as changes in the function of the intestinal mucosal barrier. Additionally, we presented the potential and challenges of microbial therapy, which may provide microbial therapy strategies for severe burn.

Prescribed burning followed by indaziflam enhances downy brome (Bromus tectorum) control

AbstractDowny brome (Bromus tectorum L.) is a highly invasive winter annual grass that can fill open niches in native plant communities. Prescribed burning is often used to control B. tectorum and can be combined with herbicide treatments to extend the duration of control and promote the native plant community. Several herbicides have been evaluated in conjunction with burning for B. tectorum control, although the herbicide indaziflam has not. In September 2017, two B. tectorum–infested sites were burned in Colorado foothill shrublands. In March 2018, indaziflam was applied alone or in combination with glyphosate, rimsulfuron, or imazapic. These treatments were compared with imazapic plus glyphosate as a standard. All treatments were made within burned and non-burned areas in a crossed-nested design. Bromus tectorum cover and the desirable plant community responses were evaluated 1 and 2 yr after treatment (YAT). In non-burned areas, all indaziflam treatments reduced B. tectorum cover compared with the control. In contrast, reductions from the imazapic treatments did not persist after the first year. Most post-burn treatments further decreased B. tectorum cover compared with the non-burned treatments. The most effective treatments (indaziflam 44 and 73 g ai ha−1 + imazapic 123 g ae ha−1) provided similar levels of control (<1% B. tectorum cover at 2 YAT), with or without burning. Desirable plant cover, richness, and diversity were not negatively impacted by burning or herbicide treatments. Plant diversity and species richness increased at Site 2 when burning was followed by indaziflam treatments. This study indicates that B. tectorum control using indaziflam can be enhanced when applied after burning, and the combinations with imazapic or rimsulfuron provide a wider application window compared with the combination with glyphosate.

Interleukin-6 blockade, a potential adjunct therapy for post-burn hypermetabolism.

Severe burns remain a leading cause of death and disability worldwide. Despite advances in patient care, the excessive and uncontrolled hypermetabolic stress response induced by this trauma inevitably affects every organ system causing substantial morbidity and mortality. Recent evidence suggests interleukin-6 (IL-6) is a major culprit underlying post-burn hypermetabolism. Indeed, genetic deletion of IL-6 alleviates various complications associated with poor clinical outcomes including the adverse remodeling of adipose tissue, cachexia and hepatic steatosis. Thus, pharmacological blockade of IL-6 may be a more favorable treatment option to fully restore metabolic function after injury. To test this, we investigated the safety and effectiveness of blocking IL-6 for post-burn hypermetabolism using a validated anti-IL-6 monoclonal antibody (mAb) in our experimental murine model. Here, we show daily anti-IL-6 mAb administration protects against burn-induced weight loss (P<.0001) without any adverse effect on mortality. At the organ level, post-burn treatment with the IL-6 blocker suppressed the thermogenic activation of adipose tissue (P<.01) and its associated wasting (P<.05). The reduction of browning-induced lipolysis (P<.0001) indirectly decreased hepatic lipotoxicity (P<.01) which improved liver dysfunction (P<.05). Importantly, the beneficial effects of this anti-IL-6 agent extended to the skin, reflected by the decrease in excessive collagen deposition (P<.001) and genes involved in pathologic fibrosis and scarring (P<.05). Together, our results indicate that post-burn IL-6 blockade leads to significant improvements in systemic hypermetabolism by inhibiting pathological alterations in key immunometabolic organs. These findings support the therapeutic potential of anti-IL-6 interventions to improve care, quality of life, and survival in burned patients.

The lethal heat dose for 50% primary human fibroblast cell death is 48°C.

Understanding the effect of heat on skin cells is important for the prevention of burn injury. Knowledge of the heat dose required to kill cells can be used to study the cellular mechanisms involved in thermal injury cell death, to assist with the development of novel burn treatments. In this study, primary human skin dermal fibroblasts were exposed to temperatures from 37 to 54°C for 1h and the relative cell viability of heat-treated and control cells was assessed. Cell damage and viability were assessed by light microscopy, MTT assay and live/dead staining. The LD50 for 1h of heat exposure was 48°C for primary fibroblasts; and there was evidence that thermal damage to cells begins to occur at 43°C. This study presents a reproducible method for examining the effect of heat on primary human cells grown in culture on a cellular level and can be used in the future to study the mechanisms behind heat-induced cell death, to inform burn injury prevention efforts and effective post-burn treatment.

Changes in Vegetation of Flooded Savannas Subject to Cattle Grazing and Fire in Plains of Colombia

Cattle grazing and fire are common types of management on natural ecosystems, generating several threats to the conservation of native vegetation (e.g., changes in species richness, cover, and abundance, mainly of bovine-palatable species). In this work, we analysed the response of the structure and composition of vegetation managed with different cattle stocking rates and fire in the savanna ecosystems of Colombia. The study was located in the eastern area of the Llanos region, where savannas were subjected to grazing and burning. Regarding grazing, we classified the area according to the cattle stocking rate (Bos indicus ~300 kg): NG = non-grazed, LS = low stocking rate (0.5 ind ha−1 yr−1), and HS = high stocking rate (1.0 ind ha−1 yr−1). Controlled artificial burning was applied in all the area at the beginning of the study, and surveys were conducted in the same plots at pre-burn (t0) and four post-burn times (t1, t2, t3, t4), at 15, 45, 75 and 105 days after burning. Vegetation composition (species list, life-form, palatability) and structure (bare soil and vascular plant ground covers, species height and richness) were recorded at each sampling. Data were compared through ANOVAs and multivariate analyses. We found 53 species in total: 26 in the pre-burn treatment and 44 in the post-burn treatments, detecting an increase of 18 species considering all treatments. Seven natives and two exotic species represented the dominant cover (&gt;50%). LS and HS had the highest number of palatable species in t0 (seven species) compared with NG (two species), but this became similar after burning (14 species in NG, 12 in LS, and 11 in HS). ANOVAs and multivariate analyses showed that plant assemblages were significantly different according to the grazing treatment, and more homogeneous in pre-burn than in post-burn periods. Cattle grazing favored higher covers of dominant palatable species (e.g., Axonopus purpusii) compared with NG, but many native species with high palatability only recovered within the system after burning. In the context of the current management proposals, the search for new alternatives other than intensive cattle grazing and burning is needed to reconcile human production activities, international commitments against climate change and biodiversity conservation in the savanna landscapes.

Design and clinical application of a combined shoulder abduction orthosis for post-burn treatment

Cicatricial contracture is likely to occur at the deep burn wound under the armpits after healing, which results in limitation of shoulder abduction and seriously affects the function of upper limbs of patients. Wearing shoulder abduction orthosis is an effective intervention method for cicatricial contracture under the armpits, but the adjustable shoulder abduction orthosis commonly used clinically at present is limited in the adjustable range, and the customized static orthosis can only maintain the corresponding angle of shoulder abduction. Besides, the above two orthosis can only have the function of unilateral extention, and they are time-consuming for patients with need of bilateral extension. Aiming at the problems mentioned above, a combined shoulder abduction orthosis was designed by the Tongren Hospital of Wuhan University & Wuhan Third Hospital. The low temperature thermoplastic sheet was cut, shaped, and assembled according to the patient's measurement data of abdomen, upper arm, and lumbar to prepare the combined shoulder abduction orthosis. This abduction orthosis can not only extend the cicatrix contracture under the armpits progressively and extensively, so as to effectively prevent the cicatricial contracture under the armpits, but also can select unilateral or bilateral extension based on the contracture limits for shoulder abduction, thus saving time for both medical workers and patients in relevant treatment.

Activation of ER stress signalling increases mortality after a major trauma.

The endoplasmic reticulum (ER) adapts to stress by activating a signalling cascade known as the ER stress response. While ER stress signalling is a central component of the cellular defence against environmental insult, persistent activation is thought to contribute to the progression of various metabolic complications via loss of protein function and cell death. Despite its importance however, whether and how ER stress impacts morbidity and mortality in conditions of hypermetabolism remain unclear. In this study, we discovered that chronic ER stress response plays a role in mediating adverse outcomes that occur after major trauma. Using a murine model of thermal injury, we show that induction of ER stress with Tunicamycin not only increased mortality but also resulted in hepatic damage and hepatic steatosis. Importantly, post‐burn treatment with chaperone ER stress inhibitors attenuated hepatic ER stress and improved organ function following injury. Our study identifies ER stress as a potential hub of the signalling network affecting multiple aspects of metabolism after major trauma and as a novel potential molecular target to improve the clinical outcomes of severely burned patients.

The effects of epidermal growth factor on early burn-wound progression in rats.

After burns, protecting tissues by medicines in the zone of stasis reduces the width and depth of injury. This study's goal was to reduce burned tissue damage in the zone of stasis using epidermal growth factor (EGF). Forty-eight Wistar rats were separated into three groups. In all groups, the burn procedure was applied following the comb burn model. In Group 1, no postburn treatment was administered. In Group 2, physiological saline solution (0.3 cc) was injected intradermally and in Group 3, EGF (0.3 cc) was injected intradermally into stasis zone tissues after the burn procedure. Surviving tissue rates were 24.0% in Group 1, 25.3% in Group 2, and 70.2% in Group 3. The average numbers of cells stained with Nrf2, HO-1, and the number of apoptotic cells were 230, 150, and 17.5 in Group 1, 230, 145, and 15.0 in Group 2, and 370, 230, and 0 in Group 3, respectively. Values in Group 3 were found to be statistically significantly different than those of Groups 1 and 2; there was no difference between Groups 1 and 2. This study shows that EGF protects zone of stasis tissue from burn damage.

Vascular perfusion: A predictive tool for thermal burn injury

Damage to the blood vascular system and their altered permeability is a prominent pathological event in case of dermal injury, particularly in burn trauma situations. Prediction of vascular perfusion at the site of damage could be an attractive tool in the estimation of thermal burn injury. A very few reports are available with reference to this tool in defining the thermal injury status. We have used the vascular perfusion estimation method as a tool in assessing the severity of thermal damage to the animal skin. To validate this tool, the mice were subjected to the thermal burn at 90 °C for 10, 20 & 30 s and excised burned skin samples were analyzed for vascular perfusion 24hr post-burn treatment. The vascular perfusion was significantly altered in a time-dependent fashion. This method also provided information regarding blood vessel damage at varied time points. The results of this study clearly indicate the severity of skin damage by the thermal burn. The finding of the present study could have greater implications in predicting the degree of burn. This method is very simple and cost-effective compared to other available modalities used for the estimation of thermal burn injury. The method certainly has the benefit of the estimation of burn injury in the animal models.

Asprosin: Possible target in connection with ghrelin and cytokine network expression in the post-burn treatment

Burn injury is a severe form of trauma associated with pain, metabolic abnormalities, susceptibility to infections, muscle loss, mental and emotional distress. Conventional therapies as well as some recent approaches for the treatment of burned patients are currently in use. Nutritional therapy is also suggested as a supplementary option in major burns. Within this context, hormones involved in the regulation of appetite will have a paramount importance. The aim is to evaluate the interactions among ghrelin, some inflammatory parameters and the burn injury. Asprosin is also involved into this discussion due to its ghrelin-like actions.Aside from the consideration of insulin as well as stress hormones (cortisol, epinephrine, norepinephrine), an orexigenic, anti-inflammatory hormone, ghrelin affecting both metabolic and inflammatory systems is also involved in the protocols designed for burn treatment. Ghrelin’s actions exerted by way of growth-hormone secretagogue receptor, neuropeptide Y, agouti-related protein, proopiomelanocortin and gamma amino butyric acid are being investigated. Asprosin, one of the remarkably few hormones identified as appetite stimulator, acts as another orexigenic hormone by using almost the same signalling pathways as those of ghrelin. Interleukin-6 should also be evaluated both as a reliable biomarker of inflammation and also with its inhibitory effects on TNF-α within the scope of burn injury.In conclusion, treatment protocols during burn injury may be designed to raise decreased concentrations of ghrelin and to repress increased levels of inflammatory agents such as TNF-α. IL-6 may be evaluated from an entirely different aspect. The potential therapeutic use of asprosin may be considered within an integrative approach with a focus on cachexia-anorexia developed in severe burn trauma.

Camphor Burns on the Palm: An Unusual New Presentation.

Introduction:Camphor burns on the palm are uncommon and rarely encountered by a plastic surgeon.Aim:This study aims to analyze different patterns of camphor burns on the palm.Methods:Five women and one man presented with camphor burns on their palm. All patients had burns on their right palm. The shape of camphor, the duration of contact with the ignited camphor on the palm, and post-burn treatments were evaluated.Results:Three types of camphor burns were noted: Type 1 (a ring-shaped or a dome-shaped blister with unburned skin in the center), Type 2 (an oval-shaped partially thick burn with unburned skin in the center), and Type 3 (a full-thickness burn exposing the palmar fascia).Conclusion:Different types of camphor burns on the palm are described in this study. This is the first study to report ring-shaped blisters and ring-shaped partially thick camphor burns caused on the palm.

Estimating the time and temperature relationship for causation of deep-partial thickness skin burns

The objective of this study is to develop and present a simple procedure for evaluating the temperature and exposure-time conditions that lead to causation of a deep-partial thickness burn and the effect that the immediate post-burn thermal environment can have on the process. A computational model has been designed and applied to predict the time required for skin burns to reach a deep-partial thickness level of injury. The model includes multiple tissue layers including the epidermis, dermis, hypodermis, and subcutaneous tissue. Simulated exposure temperatures ranged from 62.8 to 87.8°C (145–190°F). Two scenarios were investigated. The first and worst case scenario was a direct exposure to water (characterized by a large convection coefficient) with the clothing left on the skin following the exposure. A second case consisted of a scald insult followed immediately by the skin being washed with cool water (20°C). For both cases, an Arrhenius injury model was applied whereby the extent and depth of injury were calculated and compared for the different post-burn treatments. In addition, injury values were compared with experiment data from the literature to assess verification of the numerical methodology. It was found that the clinical observations of injury extent agreed with the calculated values. Furthermore, inundation with cool water decreased skin temperatures more quickly than the clothing insulating case and led to a modest decrease in the burn extent.

Potential effects of prescribed savannah burning on the diet selection of forest buffalo (Syncerus caffer nanus) in Lopé National Park, Gabon

AbstractSeasonality and management are factors that may affect the diet selection of the forest buffalo (Syncerus caffer nanus). Fire is considered a major driving force in savannah systems and prescribed burning is a commonly applied conservation tool in protected areas such as Lopé National Park, Gabon. Prescribed annual fires contribute to the maintenance of open areas and provide high‐quality forage for forest buffalo, a major herbivore in the park. We used microhistological faecal analysis to determine the diet selection of forest buffalo and measured the extent of variation between a dry season, preburn and a wet season, postburn sampling period. The buffalo diet comprised mainly of monocotyledons, primarily grasses (Poaceae) and sedges (Cyperaceae). Intake of open‐area‐associated plant species was higher in the wet season, postburn treatment sampling period (97%) than the dry season, preburn sampling period (87%), which corresponded conversely to a reduction in forest‐associated Marantaceae plants (10% versus 1%). High proportions of grasses and sedges in the diet signify the importance of open areas for forest buffalo. Controlled burning as tool for maintenance of open areas may play a key role in the meta‐population management of the forest buffalo.

SIMVASTATIN ATTENUATES POSTBURN INTESTINAL TISSUE DAMAGE IN RATS.

Objective: To test the effects of early postburn treatment with statins on major postburn sepsis pathogenesis in the form of gut inflammation and transepithelial leakiness. Rationale: We and others have demonstrated intestinal structural and permeability changes within three days after major thermal injury (Critical Care Medicine 32:1730-9, 2004). These changes are associated with gut tissue inflammation and immediate postburn systemic neutrophil hyperactivation and extravasation. Here, we hypothesize that such changes can be suppressed by treatment with simvastatin which had been shown to have antiinflammatory effects that include inhibition of neutrophil extravasation (Circulation 106:2104-2110, 2002). Methods: Utilizing a rat burn model with third degree burn over 30% total body surface area, we assessed gut inflammation and transepithelial permeability three days postburn with or without daily intraperitoneal injection of simvastatin. Gut inflammation was assessed by measuring tissue myeloperoxidase (MPO) activity and nitrotyrosine immunohistochemistry. Transepithelial leakiness across ex vivo gut specimens was measured utilizing FITC-dextran-40S with an Ussing diffusion chamber. Results: Our results show a substantial increase in tissue MPO activity and nitrotyrosine immunoreactivity in rat ileum and mesenteric lymph nodes 1 to 3 days postburn. However, both MPO activity and nitrotyrosine immunolabeling were largely diminished in sham and simvastatin-treated rats. Furthermore, transepithelial large molecule leakage was increased three days postburn with evidence of paracellular transport. This leakage was also significantly attenuated in sham rats and in simvastatintreated postburn rats. Conclusion: Simvastatin treatment appears to be beneficial in preventing inflammation-mediated postburn gut tissue damage that is presumed to precipitate postburn sepsis pathogenesis. Acknowledgements: This work was supported by National NIH grant# 3 S06 GM008043-34S1 (project# 6) and by NSF BIOMRI Award# DBI-0520869.

Use of In Situ Burning as an Oil Spill Response Tool: Follow-Up of Four Case Studies

ABSTRACT Four in situ burning sites that varied widely in the physical setting, oil type, timing of the burn, and post-burn treatment were assessed 0.5–1.5 years post-burn: two condensate spills in intertidal marshes at Mosquito Bay, LA in April 2001 and near Sabine Lake, LA in February 2000; crude oil spill in a ponded wetland in Minnesota in July 2000; and a spill of diesel in a salt flat/wetland north of Great Salt Lake, UT in January 2000. When used quickly after a release, burning is most effective at reducing damage to vegetation and the areal extent of impact. Where crude oil was burned within hours after the release at the Minnesota site, the impact area was restricted to 3 acres. In contrast, the diesel in the Utah spill spread over 38 acres within 3 days. The window of opportunity for in situ burning to be an effective means of oil removal can be days to months, depending on the spill conditions. The condensate spill at Mosquito Bay site was effectively burned 6–7 days after the release was reported. For spills with snow and ice cover, burning may still be effective months later. In fact, it may be necessary to consider additional burns during thaw periods and during the final thaw. Burning will not reduce the toxic effects of the oil that occurred prior to the burn. It can, however, be very effective at reducing the extent and degree of impacts by quickly removing the remaining oil. In three of the four case studies, the area burned was significantly larger than the oiled area (up to 10 x). Healthy, green, unoiled vegetation is not always an effective fire break, particularly downwind; fires can quickly jump the kinds of fire breaks placed during spill emergencies in wetlands (e.g., vegetation laid down by the passage of airboats).

Effects of full-thickness burns on nociceptor sensitization in anesthetized rats

Burn-induced pain is often inadequately managed and its mechanisms, both peripheral and central, are poorly understood. To examine peripheral mechanisms, the effects of full-thickness burns on individual nociceptive fibers in sural nerve of anesthetized rats were studied. Additionally, the study investigated whether topical post-burn treatment with the μ-opioid receptor agonist loperamide ameliorated burn-induced pathologies. Receptive field (RF) properties of C-fibers were determined for 4 h before and after producing burns. Burns caused profound tissue damage with edema extending beyond the injury site. Injury located within or proximal to RFs of nociceptors caused rapid decreases in mechanical responsiveness or complete desensitization at the original test site. However, post-burn, RF size frequently grew to include areas of newly sensitized skin. Transient or prolonged periods of ectopic activity was recorded from some nociceptors; this was most prevalent in fibers with RFs proximal to the injury site where burn induced background firing in 60% of the population. In most cases, loperamide significantly increased mechanical thresholds, prevented sensitization of uninjured skin, and reduced discharge. These data indicate that full-thickness burns activate and/or sensitize C-nociceptors, thus probably leading to pain. As loperamide ameliorates nociceptor activation and sensitization, it is an appropriate candidate for burn pain management.

Our Clinical Experience using Cryopreserved Cadaveric Allograft for the Management of Severe Burns.

Human cadaveric allograft is the most commonly used alternative wound closure material for excised burn wounds when limited donor sites or the overall patient condition does not permit immediate grafting with autologous skin.The Skin Bank in Singapore has supplied a total of 33,000 cm(2) of cryopreserved cadaveric allograft to the Burns Centre in Singapore for the early post-burn treatment of 17 severely burned patients with body surface area (BSA) burn wounds averaging 58% (range 33-90). An average of 13% (range 3-30%) cadaveric allograft was transplanted on 17 patients. Seven patients had recovered from their burn injuries and ten patients died of multiple complications related to their burn injuries. Our clinical observation has shown good adherence of cadaveric allograft when applied on clean and debrided wound bed after 4-7 days of post-operation.The availability of cadaveric allograft permits early excision and wound coverage before the patients' condition is further compromised. Our clinical experience using cryopreserved cadaveric allograft is proving to be indispensable in the management of patients with severe burns.

Gender difference in cell-mediated immunity after thermal injury is mediated, in part, by elevated levels of interleukin-6

The gender difference in normal immune function has been well documented, however, there is only limited information regarding whether such a difference occurs after injury. To investigate this, we examined cell-mediated immune responses in male and female mice given a 15% total body surface area dorsal scald or sham injury. Both delayed-type hypersensitivity (DTH) and splenocyte proliferative responses were significantly suppressed in males at 1 day and in females at 7 and 10 days post burn (P < 0.01). The decreased splenocyte proliferation was found to be macrophage-dependent and suppression of both immune parameters corresponded with elevated interleukin-6 (IL-6) levels. Furthermore, post-burn treatment with an anti-IL-6 antibody partially restored the DTH response in males at 1 day and females at 10 days post injury and completely restored splenocyte proliferation. These data demonstrate a possible mechanism for the gender difference in cell-mediated immune responses after thermal injury.

Alpha-trinositol reduces edema formation at the site of scald injury

Background: The effects of α-trinositol (1 D -myo-inositol-1,2,6-triphosphate, IP 3) on burn-induced edema formation were investigated. Methods: Lymph flow (Q L; μl/min) and lymph-to-plasma protein ratio (C L/C P) were monitored in groups of five to six dogs before and 4 hours after (1) a 5-second 100° C or 90° C foot paw scald; (2) IP 3 (45 mg/kg intravenous bolus, then a 20 mg/kg/hr infusion) 30 minutes before or after 100° C scald, or 30 minutes after 90° C scald. Hind paw venous pressure was elevated and maintained by outflow restriction until reaching steady state Q L and (C L/C P) min. Macromolecular reflection coefficient (1 – C L/C P) was measured. Fluid filtration coefficient (K f; ml/min/mm Hg/100 gm) was calculated. Relative paw weight gain (%) was measured. Results: Compared with preburn values, scald uniformly produced significant increases in Q L, C L/C P, and K f. IP 3 significantly ( p < 0.02, ANOVA) reduced paw weight gain when given before, but not after, 100° C burn (41% ± 5% versus 18% ± 7% preburn IP 3 and 31% ± 3% postburn IP 3). Compared with 90° C burn animals, postburn treatment significantly ( p < 0.017) attenuated 4-hour increases in Q L (550 ± 87 versus 252 ± 29 μl/min), K f (0.016 ± 00 versus 0.007 ± 00 μl/min/mm/Hg/100gm), and relative paw weight gain (28% ± 3% versus 12% ± 5%). Conclusions: α-Trinositol given after a 90° C scald blunted edema formation at the site of scald, likely through reduced transmembrane fluid flux. (Surgery 1998;123:36-45.)