title: Evaporative Water Loss in Superficial to Full Thickness Burns.
abstract: BACKGROUND
  Increased evaporative water loss (EWL) in burn patients leads to dehydration and hypothermia. Early clinical studies performed with outdated hygrometers suggested a 17 to 75 times increased EWL in burns with contradicting results for the different burn depths.Our study proposals were: (1) obtain reliable data of the EWL of all burn depths, (2) compare these results with findings from earlier studies, (3) evaluate the usefulness of the EWL in differentiating between superficial and deep partial thickness burns, (4) determine the effect of Biobrane on the EWL of superficial partial thickness burns in vivo, and (5) evaluate the effect of the sterile incision foil Opraflex on the EWL in split skin graft donor sites.
  
  
  METHODS
  We measured the EWL of all burn depths in 28 patients under stable and recorded conditions regarding room temperature and humidity with a modern digital evaporimeter (Tewameter TM 300). For the first time in vivo, we also determined the effect of Biobrane on the EWL of burns and evaluated the EWL in split skin graft donor sites covered with Opraflex.
  
  
  RESULTS
  The EWL in all burn depths was significantly increased (P < 0.001) compared with unburned skin. There was no significant difference (P > 0.05) in the EWL of superficial compared with deep partial thickness burns, whereas full thickness burns had a significantly lower EWL (P < 0.05) compared with superficial and deep partial thickness burns. Biobrane significantly reduced the EWL (P < 0.05) of superficial partial thickness burns. The EWL of Opraflex covered skin graft donor sites was significantly reduced compared with uncovered donor sites (P < 0.05).
  
  
  CONCLUSIONS
  Our data suggest that the actual EWL in burns is approximately 3 times higher in full thickness burns and approximately 4 times higher in superficial and deep partial thickness burns compared with normal skin and therefore much lower than suggested previously.Because there was no significant difference in the EWL of superficial compared with deep partial thickness burns, the EWL cannot be used to differentiate between these burn depths.Biosynthetic wound dressings can significantly reduce the EWL of superficial partial thickness burns and sterile incision foil protects split skin graft donor sites from an increased EWL.
authors.affiliation: From the *Department of Plastic and Aesthetic Surgery, Burn Surgery, Klinikum Leverkusen, Leverkusen; †Department of Urology, KRH Klinikum Großburgwedel, Burgwedel; ‡Department of Aesthetic and Plastic Surgery, Sana Klinikum Hameln Pyrmont, Hameln; and §Department of Plastic, Hand, and Reconstructive Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Marc Nicolai
authors.initials: MN
authors.lastname: Busche
authors.forename: Anne
authors.initials: A
authors.lastname: Roettger
authors.forename: Christian
authors.initials: C
authors.lastname: Herold
authors.forename: Peter Maria
authors.initials: PM
authors.lastname: Vogt
authors.forename: Hans-Oliver
authors.initials: HO
authors.lastname: Rennekampff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D016038:Skin Transplantation; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014870:Water Loss, Insensible / Q000502:physiology*; D055815:Young Adult
chemical_list: C042816:Biobrane; D020099:Coated Materials, Biocompatible