Background and Objective:

Tangential debridement and autograft have been the gold standard surgical treatment of deep burns. Nowadays, the availability of non surgical enzymatic debridement techniques, such as Nexobrid® has introduced a new concept in the treatment of burn patients, allowing an increase in the selectivity for the scar removal leading to the preservation of healthy dermis, reducing scarring, improving cosmetic outcome, and even more, minimizing aggression to the patient.

Prontosan® Wound Gel is a hydrogel with antibacterial properties that can be used to keep wound bed moist, without interfering epithelialization.

We present our experience with these combined products in deep dermal and/or subdermal burns affecting face, upper and lower extremities, perineal and trunk.

Methods:

All patients with deep dermal and/or subdermal burns treated with Nexobrid® in our Burn Unit between December 2015 and February 2017 were included. Enzymatic debridement was performed within the first 24 hours, applied up to 15% of body surface. After that, Prontosan® was applied and Varihesive® was used as a sealed dressing. Whenever grafting was necessary, it was performed in operating room adding split thickness grafts.

Variables collected were: age, sex, agent, extension, location and depth of the burn, period of hospitalization, location, extension and depth of the burn in the area where Nexobrid® was applied, efficacy of enzymatic debridement, needing for surgical debridement, needing of grafting, time to epithelialization and complications.

Results:

Seventeen patients with 3 to 55% burn body surface were included. Initial enzymatic debridement was complete in all patients. Only 5 patients needed split thickness grafting. Complete epithelialization was achieved on an average of 15 days. Histopathology studies were performed on 3 patients.

Histopathology findings correlated to the clinical efficacy of the debridement in 1 out of the 3 cases, and to the clinical diagnosis of the burn in the 3 cases.

After 7 months follow up, no patients required surgery for correction of sequelae.

Conclusions:

In our preliminary experience, combines use of Nexobrid® and Prontosan® Wound Gel seems a feasible alternative in the treatment of facial, upper and lower extremities and trunk burns.

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