thromboplastin and Burns

Excessive bleeding is a major concern in scar debridement and grafting procedures. TT-173 is a new topical hemostatic agent based on recombinant human tissue factor that has shown promising results in patients who underwent tooth extraction. EHTIC study sought to evaluate the efficacy and safety of TT-173 to reduce the bleeding in donor sites of skin grafting procedures.. EHTIC study was a phase II, randomized, parallel, double blind, placebo controlled trial. Patients received TT-173 (n=38) or placebo (n=33) sprayed over donor site after graft harvest. Time to hemostasis and incidence of adverse events were recorded. Systemic absorption of the product and its immunogenicity were also measured during the follow up of the subjects.. Treatment with TT-173 significantly reduced the bleeding time from 7 to 3min (Log-Rank p<0.0001). Moreover, bleeding stopped within the 10min of evaluation period in all the patients that received TT-173. In contrast, 24.24% of patients from placebo group required additional measures to arrest hemorrhage (Fisher p=0.0013). Product related adverse events, systemic absorption into blood stream, interferences with the healing of the donor site or immunogenic reaction against TT-173 were not observed.. The new hemostatic agent TT-173 has proven efficacious and safe to reduce the bleeding from donor site. This study paves the way for further investigation of the product as topical hemostatic treatment in plastic surgery and other surgical indications.

Topics: Adult; Blood Loss, Surgical; Burns; Double-Blind Method; Female; Hemostatics; Humans; Male; Middle Aged; Recombinant Proteins; Skin Transplantation; Thromboplastin; Treatment Outcome; Wounds and Injuries

Thermal skin burns cause local injury as well as triggers acute systemic inflammation response where the imbalance between oxidative and antioxidative system occurs. As an alternative treatment, various medicinal herbs are used to treat burn injuries in many countries. In this study, the possible protective role of oral or topical Myrtle (Myrtus communis L.) treatment against burn-induced damage was investigated. The dorsum of the Wistar Albino rats was shaved and exposed to 90 °C water bath in burn group or 25 °C water bath in control group for 10 s under ether anesthesia. Myrtle extract was applied 100 mg/kg/day for 2 days either orally or topically. In skin samples; malondialdehyde and glutathione levels, catalase, superoxide dismutase, nitric oxide and tissue factor activities were determined. Skin tissues were also examined by light microscopy. Severe thermal skin burn injury caused a significant decrease in glutathione level, superoxide dismutase, catalase and tissue factor activities as well as nitric oxide level, which was accompanied with significant increases in skin malondialdehyde level. Myrtle treatment reversed all these biochemical indices except topical Myrtle treated group's nitric oxide level, as well as histopathological alterations, which were induced by thermal trauma. Both oral and topical Myrtle extract treatment was found to have protective role in the burn induced oxidative injury, which may be attributed to the potential antioxidant effect of Myrtle. As a conclusion, Myrtle significantly diminishes burn-induced damage in skin.

Topics: Administration, Cutaneous; Administration, Oral; Animals; Antioxidants; Burns; Catalase; Glutathione; Malondialdehyde; Myrtus; Nitric Oxide; Oxidative Stress; Plant Extracts; Rats; Rats, Wistar; Skin; Superoxide Dismutase; Thromboplastin

An elevated procoagulant activity observed in trauma patients is, in part, related to tissue factor (TF) located on blood cells and microparticles. However, analysis of trauma patient plasma indicates that there are other contributor(s) to the procoagulant activity. We hypothesize that factor (F)XIa and FIXa are responsible for an additional procoagulant activity in burn patients.. Multiple time-point plasma samples from 56 burn patients (total number of samples was 471; up to 20 time-points/patient collected in 3 weeks following admission) were evaluated in a thrombin generation assay using inhibitory antibodies to TF, FIXa and FXIa.. Due to the limited volume of some samples, not all were analyzed for all three proteins. At admission, 10 of 53 patients (19%) had active TF, 53 of 55 (96%) had FXIa and 48 of 55 (87%) had FIXa in their plasma. 34 patients of 56 enrolled (61%) showed TF activity at one or more time-points. All patients had FXIa and 96% had FIXa at one or more time-points. Overall, TF was observed in 99 of 455 samples analyzed (22%), FXIa in 424 of 471 (90%) and FIXa in 244 of 471 (52%). The concentration of TF was relatively low and varied between 0 and 2.1pM, whereas that of FXIa was higher, exceeding 100pM in some samples. The majority of samples with FIXa had it at sub-nanomolar concentrations. No TF, FXIa and FIXa activity was detected in plasma from healthy individuals.. For the first time reported, the majority of plasma samples from burn patients have active FXIa and FIXa, with a significant fraction of them having active TF. The concentration of all three proteins varies in a wide range.

Topics: Adolescent; Adult; Aged; Body Surface Area; Burns; Factor IXa; Factor XIa; Female; Humans; Length of Stay; Male; Middle Aged; Thromboplastin; Trauma Severity Indices; Young Adult

We believe that toxic events observed after thermal injury may be caused by the release of normally intracellular substances into the circulation. We define these substances as 'metabolic' factors. Analysis of extracts prepared from normal and burned mouse skin indicates that the burned skin extract contains increased clot-promoting (Thromboplastin-like) substances and, perhaps, less RNA than normal skin extracts. Injection of RNA or its breakdown products into the burned site significantly increases the acute mortality in burned mice. No increase in mortality is observed when these substances are injected into a non-burned site on burned mice. We suggest that 'Thromboplastin-like substances and RNA or RNA breakdown products may be some of the 'metabolic' factors involved in acute burn toxicity. Upon being released from their intracellular residence after thermal injury, their combined activity contributes to the acute mortality observed.

Topics: Animals; Burns; DNA; Female; Mice; Nucleic Acids; RNA; Skin; Thromboplastin; Toxemia

Major surgical procedures are now performed with acceptable risk on patients with hemophilia A with pre- and postoperative anti-hemopilic Factor (AHF) infusions. However, there is almost no literature on care of the burned hemophiliac. We recently treated a patient with Factor VIII levels of less than 2% of normal and 45% TBSA burns. A forearm escharotomy was done with hemostatic protection by AHF infusion, but burn therapy, which included operative debridement and successful split-thickness skin grafting, was accomplished without the use of AHF. It is concluded that after early loading with cryoprecipitate, burned hemophiliacs do not require continued AHF, because repair and restoration of vascular integrity in small vessels may occur due to platelet plugging and vessel retraction. Tissue thromboplastin may also contribute to clotting in burned hemophiliacs.

Topics: Adult; Blood Coagulation; Burns; Cryoglobulins; Debridement; Factor VIII; Hemophilia A; Humans; Male; Microcirculation; Risk; Skin Transplantation; Thromboplastin; Transplantation, Autologous

Seventy-seven major thermal injury victims were studied with a number of hematologic and immunologic tests initially and sequentially during the first postburn month. The patients were grouped by initial prognostic index as well as by ultimate survival. Pairs were grouped by initial prognostic index as well as by ultimate survival. Pairs of test data from subjects studied at successive time intervals were compared with prognostic index and ultimate survival. Statistically significant changes in coagulation, fibrinolytic, complement, and kinin tests all occurred within these groups. These findings strongly suggest that intravascular contamination occurs following thermal injury in proportion to the extent of the burn, because of the occurrence and persistence of statistically significant multiple system changes. Regrouping all of the blood data according to ultimate death or survival reinforced the concept of intravascular contamination and provided the basis by which one can compute laboratory prognostic indices. The combination of plasminogen, C'3 complement, C'H50, one-minute kinin, and TEG index discriminated between death and survival with 91% accuracy by the end of the first postburn week. These data offer the potential for select blood measurements in refining current prognostic indicators. This may provide an objective data base for the analysis of new treatment programs in thermal injury victims.

Topics: Blood Cell Count; Blood Platelets; Burns; Complement System Proteins; Fibrin Fibrinogen Degradation Products; Fibrinogen; Hematocrit; Humans; Kallikreins; Plasminogen; Prognosis; Prothrombin Time; Thrombelastography; Thromboplastin

Topics: Blood Cell Count; Blood Coagulation; Blood Platelets; Burns; Craniocerebral Trauma; Fibrinogen; Fibrinolysin; Fibrinolysis; Humans; Prothrombin Time; Thromboplastin; Wounds and Injuries

Topics: Animals; Blood Circulation; Blood Coagulation; Blood Vessels; Burns; Dogs; Erythrocytes; Female; Fibrinolysis; Injections, Intravenous; Male; Mesentery; Methods; Prothrombin Time; Regional Blood Flow; Streptokinase; Thromboplastin

Topics: Adsorption; Animals; Antitoxins; Burns; Female; Humans; In Vitro Techniques; Injections, Intravenous; Methods; Mice; Prothrombin Time; Skin; Thromboplastin; Toxins, Biological

Topics: Autografts; Blood Coagulation Tests; Burns; Hemophilia A; Hemostatics; Humans; Skin Transplantation; Thromboplastin; Transplantation, Autologous

Topics: Animals; Brain; Burns; Carbon Isotopes; Heparin; Injections; Injections, Intraperitoneal; Mice; Mortality; Muscles; Pharmacology; Radiometry; Research; Shock, Traumatic; Skin; Sodium; Sodium Chloride; Sodium, Dietary; Thromboplastin; Tissue Extracts; Tourniquets; Toxicology

Topics: Animals; Blood Coagulation Disorders; Burns; Heparin; Infusions, Parenteral; Injections; Injections, Intravenous; Mice; Prothrombin Time; Research; Shock; Skin; Thromboplastin; Tissue Extracts

Topics: Animals; Blood Coagulation Disorders; Burns; Hematocrit; Heparin; Mice; Research; Skin; Thrombophilia; Thromboplastin; Tissue Extracts

Topics: Animals; Burns; Cortisone; Inositol; Phosphatidylinositols; Phospholipids; Rats; Thromboplastin