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Use of POR-8 in the management of burned children
Insights
Sub-eschar infiltration with Para-Ornithin-8-Vasopressin (POR 8) significantly reduces bleeding during pediatric burn surgery. This technique allows for large area excision and grafting with excellent results and no observed complications.
Area of Science:
- Medicine
- Surgery
- Pediatrics
Background:
- Paediatric burn management often involves conservative treatment followed by excision and grafting.
- Excessive bleeding during tangential excision can complicate surgical outcomes.
Purpose of the Study:
- To evaluate the efficacy of sub-eschar infiltration with Para-Ornithin-8-Vasopressin (POR 8) in reducing bleeding during paediatric burn surgery.
- To assess the safety and effectiveness of POR 8 in both excision sites and donor sites.
Main Methods:
- Sub-eschar infiltration with POR 8 was performed on 145 children undergoing tangential excision for burns.
- POR 8 was also used for donor site infiltration in 25 children.
- Surgical outcomes, graft take rates, and patient vitals were monitored.
Main Results:
- Dramatic reduction in bleeding during tangential excision.
- Successful excision and grafting of up to 20% total body surface area in a single operation.
- Graft take rates of 95-100% were achieved.
- No significant variations in heart rate were recorded.
- A 5-10% increase in arterial blood pressure was observed.
- No general or local complications were reported.
Conclusions:
- Sub-eschar infiltration with POR 8 is a highly effective method for controlling bleeding in paediatric burn surgery.
- The technique facilitates large-scale excision and grafting with high success rates.
- POR 8 is a safe adjunct for operative treatment of burns in children, with no observed complications.
Abstract:
In the paediatric burn unit of Brugmann University Hospital, children are treated conservatively for three weeks before excision and grafting. In order to avoid excessive bleeding during tangential excision of the granulating tissue, sub-eschar infiltration with Para-Ornithin-8-Vasopressin (POR 8), a synthetic neurohypophyseal-like hormone, has been performed since 1979 on 145 children. Bleeding is reduced dramatically by this technique. Therefore, since 1984, infiltration of the donor site with POR 8 was also performed in 25 children. Excision and grafting of areas up to 20% of total body surface are possible in one operation with a graft take rate of 95 to 100%. We didn't record any variation in heart rate. A 5 to 10% increase of arterial blood pressure occurred in all children. No general or local complications have been observed. We believe this technique to be of great help in the operative treatment of burns in children.