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Cirugía Plástica Ibero-Latinoamericana

versão On-line ISSN 1989-2055versão impressa ISSN 0376-7892

Resumo

MARTINEZ-MENDEZ, José-Ramón et al. Economics of thermal burns treatment by enzymatic debridement; the pivotal role of hospital length-of-stay. Cir. plást. iberolatinoam. [online]. 2018, vol.44, n.2, pp.161-168. ISSN 1989-2055.  http://dx.doi.org/10.4321/s0376-78922018000200006.

Background and Objective

Enzymatic debridement with Nexobrid®, a concentrate of proteolytic enzymes enriched in bromelain, represents an important therapeutic breakthrough.

Our aim is to carry out an economic analysis of the treatment of thermal burns with Nexobrid®, researching the cost determinants.

Methods

We analyzed retrospectively the resources used in the treat-ment by enzymatic debridement with Nexobrid® of wounds by thermal burn of superficial/deep partial and full-thickness, of the adult patients admitted consecutively in our hospital (2014-2016). Participation of each resource in total cost was analyzed for some patient subgroups.

Results

Seventy one patients were analyzed: age: 45.4 years; men: 73.2%; flame wound: 64.8%; full-thickness burn: 77.5%; Total Body Surface Area ≤10%: 70.4%. Average cost per patient was estimated in €20.844 (range: €2.192-€145.198); 68.1% was associated to length of Critical Burn Unit and conventional hospital stay. Cost of full-thickness burns was significantly higher than that of the superficial (p=0.013) and deep partial ones (p=0.0004). Total Body Surface Area leaded a significant cost difference (p<0.0001), showing a high correlation (R2=0.77) with the total hospital length of stay.

Conclusions

Hospital length of stay (Critical Burn Unit and conventional hospital) is the main cost determinant of the treatment of thermal burns of superficial/deep partial and full-thickness with enzymatic debridement (48.7% and 19.4%, respectively); Nexobrid® contributes only with 13.9% of total cost. Likewise, total body surface area shows a strong correlation with length of stay.

Palavras-chave : Burns; Bromelain; Enzymatic debridement; Cost analysis.

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