Journal of AdvancedMedical and Dental Sciences Research

Background: Burn has high mortality and morbidity rates not only in India, but worldwide. Heparin has been treatment of choice since years. This study was aimed at comparing the conventional and topical heparin for the management of burns. Materials & Methods: This study was conducted in the department of general surgery from January 2013 to June 2014. This study comprised of 60 patients (males- 28, females -32) in the age range from 20-45 years.  All patients were divided into 2 groups consisting of 30 patients each. Group I patients were put on topical heparin. Group II patients were put on conventional treatment. In group I, wounds were left exposed and received 4,200 UI of heparin for each 1% of affected body surface three times daily until the crusts appeared.  We used spray with 10,000 UI of unfractionated heparin per ml. Each spray releases 0.14 ml of the product, corresponding to 1,400 UI of heparin. Patients received daily hygiene care in bed.  In group II, balneotherapy was used and silver sulfadiazine dressings changed under analgesia.  Morphine (0.05 mg/kg) intravenously was given to all patients; 750 mg of paracetamol was given orally in case of fever and in case of thrombo-embolism prophylaxis, 5,000 UI of heparin was given subcutaneously two times daily. Other medications, hemoderivatives and procedures were provided to all patients whenever needed. TTPA increase, thrombocytopenia, hepatotoxicity, and hypercalcemia level was assessed. Heparin’s analgesic efficacy and tolerability was evaluated by the analgesics´ demand and response to the pain Visual Analog Scale. Results: We include 60 patients (males- 30, females- 30). The difference was non significant (P-1). Group I (Heparin) consisted of 30 patients (males-15, females- 15) and group II (conventional) comprised of 30 patients (males-15, females- 15). The difference was non significant (p-1). We compared day 1, day 7, day 15 and day 21 in both groups. The group I required less analgesics as compared to group I. The difference was significant (P-0.01). The VAS score was assessed and compared in day 1, day 7, day 15 and day 21 in both groups. The group I showed lower VAS scale as compared to group II. The difference was significant among both the groups. Most common adverse effect was elevated TGP in group I (3) and group II (2), local pain seen in group I (3), group II (1) patients followed by anemia in group I (1), coma in group I (1) and group II (1) and constipation (1) in group II. The difference was non significant (P-0.1). Other adverse effects were local infection in group I (18) and group II (20), septicemia in group I (8) and group II (7), fever in group I (3) and group II (8), hypertension in group I (3) and group II (4) and hematuria in group I (2) and group II (1). Conclusion: Author concluded that topical heparin in effective in managing burns. The analgesic effectiveness is more with the topical heparin as compared to conventional treatment. Adverse effects are less with heparin.
Key Words: Burn, Heparin, septicemia

Corresponding Author: Dr. Satish Chandra, MS (Surgery), Assistant Professor, Mayo Medical College, Barabanki, U.P., India  

This article may be cited as: Chandra S. Management of burns by conventional & topical heparin: A comparative study. J Adv Med Dent Scie Res 2016;4(6):121-124.