Burn injury is a major public health issue in developing nations. The objectives of this work were to evaluate how the biochemical changes of liver enzymes and amylase can help in dating of burn injury and its relation with the severity and prognosis of burns. Also, this study aimed to determine the progressive skin changes in thermal burns, with serial biopsies and to investigate the time course of leucocytes and lymphocytes infiltrations, and finally, to study the effects of burn on CD4 and CD8 T cells in relation to time and severity of the injury. The study was conducted on 50 burned-patients admitted to the Burn Unit, Department of Plastic surgery, Benha Educational Hospital-Egypt; during the period from the 1st of September 2009 to the end of October 2010. Blood samples were taken at admission time, 5th and 10th post-burn days and skin biopsies were obtained at 3 days, 1 week, and 2 weeks post-burn from patients who gave informed consent to go through this study. Based on the severity of burns, burn patients were classified into 2 groups; 35 (70%) patients with moderate burn and 15 (30%) patients with severe burns. All patients enrolled in this study underwent blood samples for biochemical study and skin biopsy for histopathological and immunohistochemical evaluation. Fifteen clinically health individuals were submitted to the biochemical study as a control group, while the control group for burnt skin biopsy study was the nearby non-involved area taken from 15 patients. Biochemical results revealed no significant increase in liver enzymes and amylase levels on admission. On 5th and 10th post-burn day, liver enzymes and amylase showed a significant elevation in comparison with control group. Also, there was a non significant correlation between the severity of burn and liver enzymes and amylase at the time of admission and a significant correlation on 5th or 10th post-burn day. At the same time, it was found that there was a non-significant difference in the mean values of AST, ALT, ALP and amylase in surviving and dead cases. The examination of skin biopsy at 3 days, 1 week, and 2 weeks post-burn revealed progressive histopathological changes which can help in dating of burn and can be used as an indicator of burn severity. Immunohistochemical study revealed that burn injury was accompanied by marked immunodeficiency. |
