The use of pH to determine the depth of dermal burns and treatment choice

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The use of pH to determine the depth of dermal burns and treatment choice

Journal Title: Хірургія України - Year 2018, Vol 0, Issue 3

Abstract

The aim — to increase the effectiveness of treatment in patients with dermal burns by applying pH meters to determine the depth of dermal burns and the choice treatment. Materials and methods. The results of examination and treatment of 170 patients with dermal burns with the 5 — 40 % TBSA have been analyzed. During the first, second and third day, a series of pH meters were performed: pH meter on the unharmed skin of the homologous segment, pH meter on different sites of the wound, around the wound. The pH of the wound was measured by a pH meter with a flat electrode for the skin. Clinical, biochemical, statistical methods of study were carried out. The accuracy, sensitivity and specificity of the tested method has been proved. Results and discussion. A series of pH meters were used as the basis for calculating the constant pH for each degree of burn. The values of burn depth parameters were compared with the histopathological assessment and the clinical outcome at patient discharge. The average pH after the first day for epidermal burns, which healed for 7 — 10 days, was 7.6 ± 0.1 units, for dermal superficial burns healed within 3 weeks — 8.3 ± 0.2 units and for deep dermal burns that did not heal on their own during the study period — 8.9 ± 0.3 units. The pH difference in more than 3 units was detected in 80 patients from the main group with dermal burn, pain was absent in these areas of wounds in the pain test, deep necrosis was determined visually, indicating the presence of deep dermis burns among these patients. All patients underwent early excision of necrotic tissues with plastic wounds. 20 % of the comparison group lacked the objective diagnostics at the early stage leading to delay in surgical intervention, which in turn caused a prolonged duration of a hospital stay. The high sensitivity of the pH test was determined 24 hours after the injury. Probability of the diagnosing the depth of a burn wound 24 hours after the injury by the pH metric test was equal to 84 %. Specificity of the test — 95 %. Conclusions. The contact pH metric for wounds in patients with dermal burns is an objective method to determine the depth of thermal damage in the early stages after the injury as well as predict the course of the wound process. The difference in the pH of the homologous segments one day after the injury (D pH) equal to 2 units is a clear indication for the presence of superficial dermal burns. The pH difference D pH іn 4 units demonstrates the presence of deep dermal burns and is an indication for early surgical treatment.

Authors and Affiliations

O. M. Kovalenko, A. O. Kovalenko

Keywords

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EP ID EP415753
DOI 10.30978/SU2018-3-38
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