Abstract

CORRALES-BENITEZ, Carlos et al. Reduced need for grafting and low incidence of hypertrophic scarring in burns after enzymatic debridement. Cir. plást. iberolatinoam. [online]. 2016, vol.42, n.4, pp.339-346. ISSN 1989-2055.

Background and Objective: Early burn scar removal is the standard of care for burn patients; excisional debridement, however, often leads to excision of dermal remnants, making autografting unavoidable. Enzymatic debridement with proteolytic enzymes enriched in Bromelain (Nexobrid^®) leaves these dermal remnants to allow spontaneous healing of partial thickness burns. This study evaluates if Nexobrid^® (MediWound Ltd., Israel) reduces the need for surgery and autografting in intermediate and deepdermal burns, the reduction in the excised and grafted area, and the development of hypertrophic scarring. Patients and Methods: We conduct a prospective study between January 2015 and February 2016 evaluating 36 patients (11 females, 25 males) whose mean age was 42.89, with burns covering a mean of 7.47% of their total body surface area (6.42% deep burns). All patients would need excision and autografting as their previous standard of care. Results: After enzymatic debridement, only 13 patients (36.1%) needed surgery (p < 0.001). The area of burns excised and grafted was reduced (2.67% vs. 4.98% p < 0.001). Since wound closure was delayed until 25.69 days, only 11.1% of the patients developed hypertrophic scars. Conclusions: Nexobrid^® allows scar removal in deep-dermal and intermediate burns, reducing the need of surgery and the grafted body surface area, while achieving good scars.

Keywords : Burns; Enzymatic debridement; Bromelain; Autografting; Hypertrophic scar.

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