Pathophysiology of Hemostatic Disorders in Septicotoxemic Burns
Abstract
Background: Burn injuries are frequently complicated by septic complications, leading to disturbances in the hemostatic system. This study evaluates the impact of burn severity on coagulation parameters, fibrinolytic activity, and microcirculatory changes in 59 patients aged 18–79 years. Methods: Patients were stratified by burn severity into three groups according to the Frank index. Coagulation parameters, fibrinogen levels, thrombotest, plasma recalcification time, and platelet counts were monitored. Early necroectomy and autodermoplasty using the local hemostatic agent “Heprocel” were performed. Morphological studies were conducted on 19 deceased patients to evaluate microvascular thrombotic changes. Results: Burn severity significantly affected coagulation parameters during septic progression. Early surgical intervention combined with local hemostatic therapy restored hemostatic balance and promoted graft integration. Morphologically, microthrombi, fibrin strands, and tissue necrosis were predominant in lungs, kidneys, liver, heart, and brain. Conclusions: Severe burns induce hypercoagulation, thrombocytopenia, and microvascular thrombotic phenomena, leading to critical organ dysfunction. Early identification and correction of hemostatic disorders, along with adequate surgical and hemostatic therapy, significantly improve outcomes.