Enzymatic debridement in scalds is not as effective as in flame burns regarding additional eschar excision: A retrospective matched-control study |
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| Affiliation: | 1. Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran;2. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Islamic Azad University, Urmia, Iran;3. Department of Medical Physics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran;4. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran;5. Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran;6. Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran;7. Quchan School of Nursing, Mashhad University of Medical Sciences, Mashhad, Iran;1. Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Canada;2. Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Canada;1. 903rd Hospital of People Liberation Army (PLA), Hangzhou, Zhejiang, China;2. The First Affiliated Hospital of Naval Medical University, Yangpu, Shanghai, China;1. AP-HP, GH St-Louis-Lariboisière, Department of Anesthesiology and Critical Care and Burn Unit, DMU PARABOL, FHU PROMICE, Paris, France;2. Université de Paris, France;3. UMR INSERM 942, Institut National de la Santé et de la Recherche Médicale (INSERM), France;4. F-CRIN INICRCT Network, Nancy, France;5. AP-HP, GH Saint-Louis-Lariboisière, Department of Infectious Disease, Paris, France;6. AP-HP, GH Saint-Louis-Lariboisière, Department of Plastic Surgery and Burn Unit, Paris, France;7. AP-HP, GH Saint-Louis-Lariboisière, Department of Virology, Paris, France;8. Department of Anesthesia and Perioperative Care, University of California, 500 Parnassus Avenue MUE416, Box 0648, San Francisco, CA 94143, USA |
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| Abstract: | ObjectiveEnzymatic debridement of burn eschar became an accepted and widely used technique for burn wound treatment over the last years. However, this practice is not exempt from failure and recent experimental studies indicate that it may not be as efficient in scalds as in flame burns.MethodsPatients that were admitted to the burn intensive care unit between June 2017 and February 2021 and received enzymatic debridement within the first 72 h after scald and flame burn were included. Patients with scald burns were matched regarding age, sex and per cent total body surface area (%TBSA) burned in a 1:2 ratio with patients presenting with flame burns.ResultsEighteen patients with scald burns were matched with 36 with flame burns. After matching, both groups were similar in terms of age (flame burns 44.5 ± 21.1 years vs. scald 41.8 ± 22.6 years, p = 0.666), and %TBSA burned (11.0 ± 8.2% vs. 10.6 ± 9.6%, p = 0.851). Patients with scald burns significantly more often underwent further surgical eschar excision compared to controls (scald 16 (88.9%) vs. flame 19 (52.8%), p = 0.016). Length of stay per %TBSA was significantly longer in scald burns (scald 7.8 ± 9.2 days vs. flame 3.7 ± 3.8, p = 0.013).ConclusionThis study indicates that enzymatic debridement may not be as effective in scalds as in flame burns. It was shown that patients with scalds and subsequent enzymatic debridement more frequently underwent additional surgical intervention and that the size of the transplanted area was larger compared to control. Moreover, those patients had a longer length of stay at the hospital per %TBSA burned. |
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| Keywords: | Burns Scald Efficacy Enzymatic debridement Nexobrid |
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