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Cirugía Plástica Ibero-Latinoamericana

versión On-line ISSN 1989-2055versión impresa ISSN 0376-7892


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.161-166.  Epub 08-Feb-2021. ISSN 1989-2055.

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.


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.


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.


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.

Palabras clave : Burns; Bromelain; Enzymatic debridement; Cost analysis.

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