Pathophysiological analysis of third degree burn and efficacy of total escharectomy in super early phase of burn injury

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The efficacies of super early phase total escharectomy and mediator modulation on survival rate and oxygen radical product, which was considered to associate with organ dysfunction, were studied. 1.Effect of super early phase total escharectomy on survival rate Survival rates were as followed ; 43% (3/7) in non-escharectomy, 25% (1/4) in escharectomy alone, 50% (1/2) in escharectomy and allograft and 100% (2/2) in escharectomy and direct suture closure. Super early phase escharectomy did not expand the life span of 30% third degree burn rats, unless the excisioned wound was not properly managed. 2.Effect of super early phase total escharectomy and mediator modulation oxygen radical product Plasma malondialdehyde (MDA) level at two hours after burn was not changed by super early phase total escharectomy. Mediator modulation by aspirin (50,100,200 mg/kg) intra peritoneal administration immediately after burn lowered the plasma MDA levels in any dose aspirin administration groups. 3.Effec … More t of super early phase total escharectomy and mediator modulation on eicosanoidsSuper early phase total escharectomy lowered plasma levels of thromboxane (Tx) B2 and 6keto prostaglandin (PG) F1 alpha, and aspirin lowered TxB2 levels in dependence on administered aspirin dose. TxB2/6ketoPGF1 alpha ratio was lowest in 50 mg/kg aspirin administered group, and this ratio was lower in total escharectomy subgroup compared with that in non-eschaectomy subgroup in 0,100,200 mg/kg aspirin administered groups.Conclusion ; 1.Super early phase total escharectomy in 30% third degree burn reduced vasoconstrictive and platelet aggregative mediator TxA2 production, and 50 mg/kg intra peritoneal administration of aspirin lowered TxA2/PGI2 ratio. PGI2 serves for vasodilatation and inhibits platelet aggregation. So super early phase total escharectomy and mediator modulation by 50 mg/kg administration of aspirin were considered useful to maintain the microcirculation in animal with deep degree burn. 2.For the better prognosis in super early phase escharectomy group, proper wound care for excised burned wound was considered inevitable. Less