Preliminary considerations on haemocoagulative problems following burns

ABSTRACT

Severe infection and inflammation almost invariably lead to hemostatic abnormalities, ranging from insignificant laboratory changes to severe disseminated intravascular coagulation [DIC]. The aim was to assess the effect of infection on coagulation parameters in infected burn wound that could predict for the development of DIC in those patients. This Study included 60 patients [16 male and 44 female], with mean age of 32.9 +/- 10.5 years, they were treated in burn surgery unit Mansoura University Hospitals. They were classified into two groups, group I included 38 patients with burn wound infection, and group II included 22 patients with clean burn wound [control group]. All cases were subjected to through history taking and clinical examination. For cases with infected wounds, sterile swabs were used for aspiration of deeply seated wound pus for microbiologic examination. Blood samples were collected for prothrombin time [PT], activated partial thromboplastin time [APTT], platelet count and fibrinogen concentration detection. This study revealed females [73.3%] were mostly affected by burn insults than males [26.7%]. Out of 60 studied cases 61.7% had 3rd degree of burn and 63.3% developed burn wound infection. The most frequently isolated organisms from infected wound [38] were pseudomenas aeruginosa [31.6%], E.coli [18.4%], proteus [13.2%], coagulase negative Staphylococci [coag. -ve Staph] [10.5%], while the least were anaerobes [5.3%] and Candida albicans [2.6%]. On comparing burn cases with infected wounds [gpl] to those with clean burn wound [gpll] for the hemostatic changes, there was highly significant increased both PT and APTT in gpl than gpll [Pplatelet count and fibrinogen concentration in gpl vs gpll [Psepsis decreases circulating Plateiets and interfere with hemostatic functions. Combinations of APTT, PT, fibrinogen level and platelet count are considered good screening tests for predicating DIC in those patients