Effects of Topical

Heparinization of the
burn wound ;
Pilot study
4 cases presentation
By; Dr. E. El-Tayeb
On studying the
pathophysiology of the
local burn injury ;
micro-thrombi
whatever it’s etiology
converts the zone of
stasis to a zone of
coagulation making the
Heparin sodium inhibits reactions that
lead to the clotting of blood and the
formation of fibrin clots both in vitro
and in vivo.
Heparin acts at multiple sites in the
normal coagulation system. Heparin
sodium also prevents the formation of
a stable fibrin clot by inhibiting the
activation of the fibrin stabilizing
factor.
Heparin sodium does not have
fibrinolytic activity; therefore, it
will not lyse existing clots.
topical and parenteral use of
heparin in burnt patient
produce significant
therapeutic results;
 Relieve pain,
 Enhance healing,

 decrease resuscitation fluids,

decrease lung and intestinal
complications. (Saliba M.J 1967-70-74
/Mangus D.J., Falces E., Gilchrist D.R )
many burn & non-burn
studies revealed &
confirmed, that
heparin had
anti-inflammatory
effects
(Carr J 1979 )
neoangiogenic, (Azizkhlan R.G
1980/ Macaig T. et al 1984)

collagen-restoring,
(Ramakrishnan K.M et al 2000)
And epithelializing effects
(McCarthy D.W / Ehrlich H.R 1986) in

addition to its
anticoagulating effects.
Heparin is a heterogeneous
group of straight-chain
anionic
mucopolysaccharides, called
glycosaminoglycans having
anticoagulant properties.
Heparin Sodium Injection is a
sterile solution of heparin
sodium derived from porcine
intestinal mucosa,
standardized for
anticoagulant activity.
A pilot study of 4 cases with deep dermal burns
( comparatively with symmetrical burn sites in each patient )
 8 years old child with 9% scalding at the both feet & lower

legs . The pt. presented to the burn unit 3 hours after injury.
 24 years old man with 11% hot tar burn at both feet, lower
legs . The pt. presented to the burn unit 1 hour after injury.
 38 years old female with 6% scalding at both hands &

forearms The pt. presented to the burn unit 5 hours after

injury.
 32 years old baker with 14% flame burn at both hands, lower
forearms and face . The pt. presented to the burn unit 2 hours
after injury.
These 4 patients selected from many patients
considering :
 Symmetrical areas of injury.

 age of the patients.

 Multiple types of famous burns .

 All patients considered as minor burns ( all

didn’t receive any fluids ).

 Early transfer of the pt.
1st aid measures were done for all patients
 1st child dressed with heparinized

nitrofurazone ( as a soluble dressing) to the rt.

Side & nitrofurazone only for the lt. side
.(closed)
 2nd man with hot tar burn dressed with

heparinized silver sulphadiazine for the rt.

Side & only silver sulphadiazine for the lt.
Side. (closed)
 3rd female was dressed with heparinized
povidine iodine for the rt. Side & povidine
iodine only for the lt. Side. (closed)

 4th man was heparinized nitrofurazone to the

Rt. Side & nitrofurazone only for the lt. side.
(closed) ; face treated by open technique.
Heparinization of the wound estimated as
( each 1% BSA needs 1 ampoule of heparin
sodium 5,000 IU/ml for about 10 gm of
antiseptic ointment .)

application of Such heparinized dressing was for

three times daily to prevent wound dryness;
The non-heparinized part is also dressed 3
times .
All patients received oral antibiotics & the
medical treatment for the minor burns.
All 4 patients admitted to the burn dept. to be
closely followed up.
The preliminary results for
the patients .
Early healing of the
heparinized part
significantly faster than the
non-heparinized one.
 less incidence ( after short

term follow up ) of itching &

hyperemia in the heparinized
part .
 Healing time for the Healing time for the
h.part non h.part

1st pt. 7 days 9 days

2nd pt. 11 days 16 days

3rd pt. 10 days 11 days

4th pt. 10 days 13 days

 Recommendations
Further research should
longitudinally compare the
performance of heparinized & non
heparinized dressing regarding
these items
• healing time
• early post healing problems itching
& hyperemia
• late post healing problems like
hypertrophic scarring ,keloids & ugly
scars