Burns. 10,225-226 Printed in Great Britain 225

Abstracts

CLINICAL STUDIES Renin and aldosterone activities High levels of renin activity and aldosterone were found in the plasma ofadult patients with bums cover- ing between IO and 80 per cent of the body surface area during the first 5 days after injury. There was a highly significant positive correlation between the renin activities and the aldosterone levels, and signifi- cant negative correlations between the 24 hour urinary sodium excretion and the renin and aldosterone activi- ties. Secondary elevations of renin and aldosterone activities occurred in 2 patients during the second week after injury associated with clinical deterioration and systemic sepsis.

Griffiths R. W., Millar J. G. B., Albano J. et al. (I 983) Observations on the activity of the renin-angio- tensin-aldosterone (RAA) system after low volume colloid resuscitation for bum injury. Ann. R. Cd. SwK. Eng. 65, 2 12.

Complement activation in burned patients The levels of complement were studied in the circu- lation of 8 adult patients with bums covering between 25 and 90 per cent of the body surface area on ad- mission to hospital and sequentially for one week. Mean classical pathway titres (CH,,) were 49 per cent below the normal mean while haemolytic C, titres were reduced by 53 per cent and C, titres by 43 per cent. The alternative pathway titres were reduced by more than 90 per cent during the same period suggest- ing preferential depletion of this pathway. This deple- tion was associated with sepsis, pneumonia and ‘shock lung’ and was still present one week after injury.

Gelfand J. A., Donelan M. and Burke J. F. (I 983) Preferential activation and depletion of the alternative complement pathway by bum injury. Ann. Surg, 198, 58.

Circulating fibronectin levels Serial fibronectin levels were determined in plasma or serum from 24 non-septic patients with bums covering between 4 and 70 per cent of the body surface area. Passive haemagglutination tests and electro-immuno- assays showed a consistent decrease in circulating fibronectin levels during the first 72 hours after burn- ing and then again during the postoperative periods.

The decreases in fibronectin concentrations were greater than the corresponding changes in plasma protein concentrations.

Grzybowski J., Dobke M., Rysinska A. et al. (I 983) Circulating fibronectin in burned patients. Bums 9. 428.

Early or late excision of hand burns A detailed assessment of the early excision and grafting of 164 hands with deep dermal bums to preserve maxi- mal function showed that early surgery offered no ad- vantage over physical therapy and primary healing in maintaining hand function. Likewise hands with more superficial bums responded equally to operative or non-operative treatment. Early excision and grafting of hands with full thickness skin loss bums tended to produce poorer results than when grafting was delayed till at least the third week after burning. Early excision and gratting of selected full thickness skin loss burns of the hands is mainly of benefit to shorten the period in hospital when burns affecting other areas of the body are of small extent.

Goodwin C. W., Maguire M. S.. McManus W. R. et al. (1983) Prospective study of bum wound excision of the hands. J. Trauma 23. 5 IO.

ANIMAL STUDIES Burning reduces drug metabolism There is hepatic dysfunction in rats with burns cover- ing 16 per cent of the body surface because there are prolonged sleeping times after giving either pentobar- bital or trichloroethane. The activity of p-nitroanisole 0-demethylase was significantly depressed in male rats at 5. IO and I7 days after burning and was more de- pressed in female rats at IO days postburn. There was a direct relationship between the extent of the burn and the degree of impairment of enzyme activity. Pre- treatment of the rats with azathioprine prevented the enzyme depression at 5 days postburn, implicating a relationship between the postbum immune response and the depressed enzyme levels.

Fruncillo R. J. and Di Gregorio G. J. (1983) The effect of thermal irtjury on drug metabolism in the rat. .I. Trawnu 23, 523.