title: C3a levels and occurrence of subdermal vascular thrombosis are age-related in deep second-degree burn wounds.
abstract: BACKGROUND
  After second-degree burns, thrombosis of the subdermal vascular plexus may occur, necessitating epifascial necrectomy instead of tangential excision to ensure split skin graft healing. Until now, no parameter has been obtained to explain this phenomenon.
  
  
  METHODS
  Thirty-four patients with deep second-degree burn wounds were divided into 2 groups. In group 1, patients' age was < 60 years, in group 2, > 60 years. In each patient, 2 microdialysis catheters were introduced into subdermal tissue of deep second-degree thermal wounds immediately after admission. Another 2 catheters were introduced in control tissue. We measured biochemical parameters (lactate, glycerol and glucose) and complement 3a (C3a) until surgery was performed. The surgically removed tissue was examined histologically.
  
  
  RESULTS
  In thermal wounds of both groups, glucose levels fell, but lactate and glycerol levels rose compared to healthy tissue. Within the first 24 hours after trauma, C3a levels were significant higher in both groups, compared with controls (P < .01). After 24 hours the levels in group 1 had fallen to nonsignificant values, while in group 2 these levels remained high until surgery was performed (P < .001). We found significantly more thrombotic blood vessels in deep dermal tissue of group 2 (P < .005). Abbreviated burn severity index score was comparable in both groups.
  
  
  CONCLUSIONS
  C3a is continuously elevated in deep second-degree burned wounds in patients > 60 years. This finding may be related to the occurrence of significantly more thrombotic blood vessels in deep dermal tissue of elderly patients. Microdialysis therapy is a useful tool to measure metabolic and immunologic parameters in thermally damaged tissue.
authors.affiliation: Department for Plastic and Hand Surgery, Burn Center, Lübeck, Germany. Machens@uni-luebeck.de
authors.forename: Hans-Günther
authors.initials: HG
authors.lastname: Machens
authors.forename: Anne
authors.initials: A
authors.lastname: Pabst
authors.forename: Maren
authors.initials: M
authors.lastname: Dreyer
authors.forename: Jörg
authors.initials: J
authors.lastname: Gliemroth
authors.forename: Siegfried
authors.initials: S
authors.lastname: Görg
authors.forename: Ludger
authors.initials: L
authors.lastname: Bahlmann
authors.forename: Stephan
authors.initials: S
authors.lastname: Klaus
authors.forename: Michael
authors.initials: M
authors.lastname: Kaun
authors.forename: Stefan
authors.initials: S
authors.lastname: Krü Ger
authors.forename: Peter
authors.initials: P
authors.lastname: Mailänder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001786:Blood Glucose / Q000378:metabolism; D002056:Burns / Q000097:blood* / Q000150:complications; D015926:Complement C3a / Q000378:metabolism*; D005990:Glycerol / Q000097:blood; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D017551:Microdialysis; D008875:Middle Aged; D013927:Thrombosis / Q000097:blood / Q000453:epidemiology*
chemical_list: D001786:Blood Glucose; D019344:Lactic Acid; D015926:Complement C3a; D005990:Glycerol