Thermal trauma causes two different types of injuries within the burn wound. First, an immediate and irreversible injury, and, second,
a delayed and partly reversible injury. It is a very common observation in burned patients that areas that initially seemed to be partial
thickness burns have to be regarded as full thickness within the next day or days. The impairment of blood flow within the zone of stasis
is due to the impairment of the vascular patency at the microvascular level. This progression is closely correlated to the degree of oedema
formation. The aim of the study was to demonstrate that applied, controlled subatmospheric pressure is useful to prevent the progression of
partial thickness burn injuries. Therefore, seven patients (mean age, 44.2 years; S.D., 22.4 years) with bilateral partial thickness hand burns
were included into this treatment protocol. The more intense injured hand was treated with controlled applied subatmospheric pressure
(V.A.C.TM ATS), the other and less injured hand conservatively by use of silver sulphadiazine creme. In the V.A.C.-treated hand a massive
hyperperfusion was observed, being a possible reason for the prevention of burn progression. Moreover, a noteworthy amount of fluid was
removed from the burn wound and a clinically obvious oedema reduction was observed in comparison to the contralateral side. In summary,
we are of the opinion, that patients with partial thickness or mixed thickness burn may benefit from the application of subatmospheric
pressure by reducing oedema formation and increasing perfusion.
© 2004 Elsevier Ltd and ISBI. All rights reserved.