<?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>S0376-78922020000200013</article-id>
<article-id pub-id-type="doi">10.4321/s0376-78922020000200013</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Perspectiva quirúrgica de los resultados del desbridamiento enzimático en grandes quemados]]></article-title>
<article-title xml:lang="en"><![CDATA[Surgical perspective of enzymatic debridement outcomes in major burns]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez Méndez]]></surname>
<given-names><![CDATA[José Ramón]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González Miranda]]></surname>
<given-names><![CDATA[Álvaro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ojeda Regidor]]></surname>
<given-names><![CDATA[Ángela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez Sánchez]]></surname>
<given-names><![CDATA[Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Casado Pérez]]></surname>
<given-names><![CDATA[César]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario La Paz Servicio de Cirugía Plástica y Quemados ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Universitario La Paz Servicio de Cirugía Plástica y Quemados ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Universitario La Paz Servicio de Cirugía Plástica y Quemados ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Universitario La Paz Servicio de Cirugía Plástica y Quemados ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Hospital Universitario La Paz Servicio de Cirugía Plástica y Quemados ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<volume>46</volume>
<fpage>75</fpage>
<lpage>84</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0376-78922020000200013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0376-78922020000200013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0376-78922020000200013&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción y objetivo El desbridamiento enzimático ha demostrado ser eficaz y rápido en su aplicación sobre quemaduras, a la vez que conservador con el tejido sano. Su uso sobre quemaduras inferiores al 15% ha mostrado reducir la cantidad de injertos, el sangrado y las escarotomías quirúrgicas. El objetivo de este estudio es comparar 2 grupos de pacientes grandes quemados, uno tratado mediante desbridamiento enzimático frente a otro tratado mediante tratamiento estándar, y su impacto en la estancia hospitalaria, necesidades de escarotomías, tiempo hasta desbridamiento, uso de hemoderivados y cantidad de cirugías durante el ingreso.  Material y método Estudio de cohortes retrospectivas con 197 pacientes (SCQ 20-50%), mayores de 18 años, tratados entre 2012 y 2017, con 2 grupos: 32 pacientes tratados con Nexobrid® para el desbridamiento enzimático, y 165 pacientes en el grupo control con desbridamiento tangencial convencional. Ambos homogéneos para SCQ, edad, sexo, mecanismo de lesión y comorbilidades.  Resultados La edad media fue de 48.4±19.4 años, con una SCQ media de 29.5±9.4%. Observamos disminución del tiempo hasta el inicio del desbridamiento de la quemadura (5.1±4.9 días en el grupo control frente a 0.8±0.9 en el grupo de desbridamiento enzimático, p&lt;0.05). El grupo de Nexobrid® presentó una reducción de la cantidad de tiempos quirúrgicos durante su ingreso, siendo de 1.9±2.0 frente a 2.6±2.1 en el grupo control. El uso de hemoderivados se redujo en un 95% durante el desbridamiento. La necesidad de escarotomías se redujo un 60%. Finalmente, el grupo de Nexobrid® tuvo un 36% menos de estancia en la Unidad de Quemados Críticos, con diferencias estadísticamente significativas.  Conclusiones La aplicación precoz del desbridamiento enzimático en grandes quemados (20-50% SCQ), permite la escarectomía completa del paciente reduciendo la necesidad de hemoderivados, el número de tiempos quirúrgicos, las escarotomías y la estancia en la unidad de cuidados intensivos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background and objective Use of enzymatic debridement has demonstrated be fast and efficient after its application over burn wounds, being more delicate over healthy tissue. Its use in burns under 15% TBSA has shown less grafting procedures, bleeding and surgical escharotomies. The aim of this study was compare 2 groups of major burns; one treated by enzymatic debridement and other treated by standard of care. Length of stay, escharotomies, time until debridement, use of blood packs and number of surgeries during hospitalization were evaluated.  Methods A retrospective cohort study was designed with 197 patients (TBSA 20-50%), older than 18 years old, treated between 2012 and 2017, and divided in 2 groups: 32 patients were debrided using Nexobrid®, and 165 patients were included in the control group. Both groups were homogeneous for TBSA, age, gender, mechanism and comorbidities index.  Results Mean age was 48.4±19.4 years, with a 29.5±9.4% of TBSA. A reduction of the number of days until the burns debridement were found, with 5.1±4.9 in the control group and 0.8±0.9 days in the enzymatic debridement group (p&lt;0.05). The number of surgeries during the hospitalization were less in the Nexobrid® group, with a reduction of 2.6±2.1 surgeries to 1.9±2.0. The number of blood packs was a 95% lower in the enzymatic debridement, and a 60% less escharotomies were observed. Finally, a shorter length of stay in the intensive care unit were found in the Nexobrid® group, with 36% less days, this difference were statistically significant.  Conclusions Early application of enzymatic debridement in major burns (20-50% TBSA) allows a complete removal of eschar reducing the blood packs use, number of surgeries, escharotomies and length of stay in the intensive care unit.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Quemados]]></kwd>
<kwd lng="es"><![CDATA[Desbridamiento enzimático]]></kwd>
<kwd lng="es"><![CDATA[Bromelaína]]></kwd>
<kwd lng="es"><![CDATA[Escarectomía]]></kwd>
<kwd lng="es"><![CDATA[Hemoderivados]]></kwd>
<kwd lng="en"><![CDATA[Burns]]></kwd>
<kwd lng="en"><![CDATA[Enzymatic debridement]]></kwd>
<kwd lng="en"><![CDATA[Bromelain]]></kwd>
<kwd lng="en"><![CDATA[Escharectomy]]></kwd>
<kwd lng="en"><![CDATA[Blood packs]]></kwd>
</kwd-group>
</article-meta>
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