Comments from Dr. SJ Oh, MD, Head of Plastic Surgery Department, Hallym Sacred Heart Hospital, and the Director of the Burn Center in the 300 active bed Burn Hospital, (reported to be the largest in the world) regarding the efforts of the Saliba Burns Institute upon receipt of invitation to present at the Fifth Asian Pacific Burns Congress in Shanghai, China:

"Since your (Drs. MJ Saliba and Alberto Reyes) visit in November and presentation, discussion, and demonstration of heparin therapy in burned patients, we (at Hallym) have used heparin on over 400 patients (in 10 months) topically only with surgical grafting as needed and necessary.

I have prepared a study of that use. I accept your offer to have me present this study which has been accepted by the Program Committee, and I will present it at the 5th Asian Pacific Burn Congress, as a Speaker in your Plenary Session on Heparin Therapy in Burns, and I will be an attending participant in your Heparin Therapy in Burns Plenary International Symposium Session, to answer questions, and have discussion."

Dr. Oh may be contacted atsjoh@hallymor.kr. 

Topical Clinical Use of Heparin in Acute Second Degree Burns

S.J. Oh, J.W. Lee, Y.C. Chang.

Plastic & Reconstructive Surgery, Hallym Burn Center, Hangang Sacred Heart Hospital, Seoul, Korea

Aims: Heparin therapy through topical or systemic application in acute burn wound has been reported in the previous literatures to improve pain relief and also reduce healing time and scar formation of burn wound. In our study we report preliminary evaluation of topical heparin effect in acute second degree burns related to sites of burns, depth of burn injury, healing time, operation rate and degree of scaring

Material and Methods: Ourclinical data collected 369 patients during last 9 months. In sex distribution male was 215, female 154. The children were the most common (143 patients). The multiple sites of burns were the most common (217 patients). Deep second-degree burns were the most common (267 patients). We apply daily over three times of topical application of heparin on the burned wound combined with closed or open dressing. Skin grafting was performed in some patients because of worry about scar formation around 10^th or 14^th burned day. We observe the appearance of healing wound during Out Patient Department follow-up.

Results: 99 patients (26.8%) among 369 patients were performed skin grafting during heparin therapy. Skin grafting was decided frequently in burns of extremity more than head and neck. 270 patients were treated their burns with topical heparin application. Hypertrophic scaring after healing of wound was developed frequently in extremity more than head and neck. But 89 patients (52.7%) among the second degree deep burns (169 patients) showed acceptable appearance after healing of wound.

Conclusion: This studydemonstrated that topical heparin therapy of the acute second-degree burns especially in the trunk; head and neck area is effective. But deep second degree burns after complete healing over three weeks can be developed hypertrophic scaring. We recommend that the second-degree deep burns should be considered skin grafting in extremity during topical heparin therapy.

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