Blisters, cooling, antithromboxanes, and healing in experimental zone-of-stasis burns.

To appraise the ability of each to improve wound healing in zone-of-stasis burns (i.e., burns becoming progressively more ischemic early postburn), 1) an antithromboxane (dipyridamol PO immediately postburn), 2) burn-wound cooling, 3) their combination, or 4) no treatment was administered to burned guinea pigs half of which had burn blisters removed immediately postburn (PB). In all groups with blisters removed whole-thickness or very deep partial-thickness skin loss occurred. In all groups with blisters intact complete reversal of ischemia occurred without necrosis and, while dipyridamol and cooling each diminished stasis early PB, only cooled wounds showed any improved retention of hair follicles at 3 weeks PB. In this model, therefore: 1) blister removal eliminated any therapeutic effect of cooling or dipyridamol; 2) in burns with blisters intact, absorbed heat appeared at least as detrimental to healing as stasis, and 3) some of the beneficial effects of cooling appeared unrelated to prevention of stasis.