<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0376-7892</journal-id>
<journal-title><![CDATA[Cirugía Plástica Ibero-Latinoamericana]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. plást. iberolatinoam.]]></abbrev-journal-title>
<issn>0376-7892</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0376-78922019000100012</article-id>
<article-id pub-id-type="doi">10.4321/s0376-78922019000100012</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Ultrasonografía cutánea: una herramienta objetiva para la toma de decisiones tras desbridamiento enzimático en pacientes quemados]]></article-title>
<article-title xml:lang="en"><![CDATA[Cutaneous ultrasonography: and objective tool for decision making after enzymatic debridement in burned patients]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fakih Gómez]]></surname>
<given-names><![CDATA[Ibrahim]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez Balado]]></surname>
<given-names><![CDATA[Adrián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lorda Barraguer]]></surname>
<given-names><![CDATA[Elena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General Universitario de Alicante Servicio de Cirugía Plástica ]]></institution>
<addr-line><![CDATA[Alicante ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital General Universitario de Alicante Servicio de Cirugía Plástica ]]></institution>
<addr-line><![CDATA[Alicante ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital General Universitario de Alicante Servicio de Cirugía Plástica ]]></institution>
<addr-line><![CDATA[Alicante ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2019</year>
</pub-date>
<volume>45</volume>
<numero>1</numero>
<fpage>73</fpage>
<lpage>80</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0376-78922019000100012&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0376-78922019000100012&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0376-78922019000100012&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción y Objetivo El desbridamiento enzimático es hoy una herramienta útil en el tratamiento precoz de las quemaduras profundas. Tras el mismo, existen diferentes protocolos de manejo de la herida en las distintas unidades de quemados, consiguiendo en algunos casos la curación espontánea y en otros necesitando injertos de piel. A día de hoy no existe ninguna herramienta objetiva para asegurar el éxito del desbridamiento, ya que el lecho de herida que deja se asemeja a una escara que puede generar confusión sobre la eficacia del producto y el manejo del paciente. El desarrollo de una técnica fiable y objetiva para la medición de la dermis remanente podría ayudar en la toma de decisiones postdesbridamiento y en consecuencia a lograr mejores resultados.  Material y Método Realizamos ultrasonografía (US) cutánea a tiempo real con sondas de alta frecuencia en 15 pacientes, 12 horas tras desbridamiento enzimático con Nexobrid®, proporcionando imágenes precisas del remanente dérmico. Medimos el grosor de la dermis en regiones que no han sufrido quemaduras y las comparamos con áreas similares desbridadas.  Resultados Todas las US de piel demostraron menor grosor dérmico en las áreas desbridadas que en las zonas no quemadas del mismo paciente. A pesar de que en todos los casos el diagnóstico visual del lecho fue similar a una escara, en un caso la US demostró la práctica ausencia de dermis y en otro persistencia de la escara. A los pocos días, ambos pacientes necesitaron injertos de piel. Todos los casos con suficiente dermis remanente curaron por epitelización espontánea.  Conclusiones La evaluación del lecho de la herida con ultrasonografía tras desbridamiento enzimático, es un método objetivo para valorar la respuesta al tratamiento. Asimismo, la medición de la dermis remanente podría proporcionar parámetros reales para predecir las oportunidades de epitelización espontánea o la necesidad de injertos de piel en pacientes quemados.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background and Objective Enzymatic debridement is an important tool in early treatment of deep burns nowadays. After it, different protocols in management of the wound bed is done in burn care units getting in some cases spontaneous healing and in others needing skin grafts. To date, there is no objective tool to ensure the success of debridement, since the remaining wound bed resembles an eschar that can generate confusion about the efficacy of the product and patient&#8217;s management The development of a reliable and objective technique for the measurement of the remaining dermis could help in the postdebridement decision making and consequently, to achieve better results.  Methods Real-time ultrasonography (US) with high-frequency probes was performed in 15 patients 12 hours after enzymatic debridement with Nexobrid®, providing accurate images of the dermal remnant. We measured dermis thickness in non-burned regions and compared them with similar debrided areas.  Results All the US skin showed less skin thickness in the debrided areas than in the non-burned areas of the same patient. Despite the fact that in all cases the visual diagnosis resembled an eschar, in one case the US showed the absence of dermis and in another persistence of the eschar. Within a few days, both patients needed skin grafts. All cases with enough remaining dermis healed by spontaneous epithelialization.  Conclusions The evaluation of the wound bed with ultrasonography after enzymatic debridement is an objective method to assess the response to treatment. Also, the measurement of the remaining dermis could provide real parameters to predict chances for spontaneous epithelialization or the need for skin grafts in burned patients.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Quemaduras]]></kwd>
<kwd lng="es"><![CDATA[Desbridamiento enzimático]]></kwd>
<kwd lng="es"><![CDATA[Ultrasonografía]]></kwd>
<kwd lng="en"><![CDATA[Burns]]></kwd>
<kwd lng="en"><![CDATA[Enzymatic debridement]]></kwd>
<kwd lng="en"><![CDATA[Ultrasonography]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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