Factor XIII in Major Burns Coagulation

This is a prospective observational pilot study in which the levels of FXIII and coagulation, anticoagulation, fibrinolysis, endothelial tissue damage and cicatrization are at the arrival of the patient to hospital, 24 hours before the first surgical intervention, 24h After the first surgical intervention, at 7 days after the first intervention and at 30 days after the thermal trauma, in this moment the healing will also be evaluated. All burn patients who meet the proposed inclusion criteria will be included and entered into the Burn Unit of the Vall d'Hebron University Hospital from the start of the study until reaching a minimum of 20 cases or a temporary term of 2 years.

• Coagulation tests (Diagnostic test), also known as Cicatrization tests: The following plasma values will be measured: prothrombin time, activated partial thromboplastin time, thrombin time, functional fibrinogen, lactate, base excess, fibrin monomers, Factor XIII, Factor XII, Factor VIII, Fact von Willebrand, Plasmin, Plasminogen, Alpha-2-antiplasmin, antithrombin, protein C, Heparan sulfate, synecan 1. Surveys on the state of healing and moisture titration will be performed using Tewamether

Primary outcomes

• Factor XIII [30 days]: Blood Coagulation Factor XIII levels

Secondary outcomes

• Prothrombin Time (PT) [30 days]: Prothrombin Time blood levels
• Activated Partial Thromboplastin Time (APTT) [30 days]: Activated Partial Thromboplastin Time blood levels
• Thrombin Time (TT) [30 days]: Thrombin Time blood levels
• Fibrinogen [30 days]: Functional fibrinogen blood levels
• Lactate [30 days]: Lactate blood levels
• Base Excess (BE) [30 days]: Base Excess blood levels
• Fibrin monomers [30 days]: Fibrin monomers blood levels
• Factor XII [30 days]: Factor XII blood levels
• Factor VIII [30 days]: Factor VIII blood levels
• Factor von Willebrand [30 days]: Factor von Willebrand blood levels
• Plasmin [30 days]: Plasmin blood levels
• Plasminogen [30 days]: Plasminogen blood levels
• Alpha-2-antiplasmin [30 days]: Alpha-2-antiplasmin blood levels
• Antithrombin (AT) [30 days]: Antithrombin blood levels
• Protein C [30 days]: Protein C blood levels
• Heparan sulfate [30 days]: Heparan sulfate blood levels
• Syndecan 1 [30 days]: Syndecan 1 blood levels
• Healing Vancouver test [30 days]: The Vancouver survey will be conducted on the state of healing
• Healing POSAS test [30 days]: The POSAS survey will be conducted on the state of healing
• Tewamether moisture titration [30 days]: Tewamether consists of two pairs of sensors to measure the humidity and temperature gradients in two different spacings
• Surgical bleeding survey [10 days]: A surgical team survey will be performed on intraoperative bleeding (during the first debridal surgery)
• Reintervention due to bleeding [11 days]: The need of reintervention because of bleeding within the next 24 hours after the first debridal surgery will be registered
• Surface debrided [10 days]: The percentage of debrided surface and type of debridement (in the first debriding surgery)
• Surgery Bleeding [15 days]: Estimated bleeding according to the modified Gross formula (in the first debriding surgery)

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Burned patients with a burned body surface of 20% or more
* Over 18 years of age

Exclusion Criteria:

* ABSI (Abbreviated Burns Severity Index) greater than or equal to 12
* Associated polytrauma
* Coagulation deficit previously known
* Treatment with anticoagulants
* Electrocution burns
* Admission into the unit after hour 6 after thermal trauma
* The refusal of the patient, familiar or responsible to participate in the study

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• Patricia Guilabert, MD, Principal investigator, Vall d'Hebron Universitary Hospital