gms | German Medical Science

Introduction: Superficial burns that heal spontaneously with minimal morbidity may progress to deep lesions that require surgical treatment and result in sequelae if kept untreated. The study aim was therefore to analyze the effect of systemic Erythropoïetin (EPO)-administration after experimental burn.

Materials and methods: The burn comb model creates four rectangular burned surfaces intercalated by 3 unburned areas prone to secondary damage by burn progression if kept untreated. 40 Wistar rats were randomized to five experimental groups (1. untreated sham animals; 2. cooling with water (CW: 17° for 20min); 3. and 4. cooling and intraperitoneal administration of 500 respectively 2500IU EPO/kg body weight (bw) starting 45min after burn induction; 5. cooling and 500IU EPO/kg bw first administered 6hrs after burn. Animals were followed until complete healing for burn surface and depth progression using planimetry respectively histology. Microcirculation was measured using laser Doppler flowmetry. Further histologic analyses were performed for angiogenic and inflammatory response.

Results: Surface and depth progression of burns occurred during the first four days and were significantly decreased with EPO500 if administered 45min after burn injury, but not with EPO500 (6hrs), EPO2500 or CW (p<0.01 vs sham). Decreased secondary burn progression was paralleled by an increased interspace perfusion only with EPO500 (45min) (p<0.01). Maintenance of microvessels (induction of nitric-oxide (NO)-synthase), increased angiogenesis, reduced ischemia-induced inflammation as well as total healing time correlated with total burn extension.

Conclusion: Systemic administration of 500IU EPO/kg bw significantly limited interspace necrosis and burn depth progression preserving skin appendages needed for regeneration only if administered 45min after burn. Protection seems to be the consequence of a NO-mediated maintenance of microcirculation. Neither the angiogenic nor the anti-inflammatory properties of EPO play any significant role in the prevention of burn progression. Yet, the results suggest that EPO constitutes an effective approach to improve clinical outcomes after thermal injury.