Abstract: | In a prospective inpatient study 130 hands with dermal and subdermal burns in 80 patients were treated with a new topical agent, Debrisan (Pharmacia AB, Sweden), which is composed of dry, porous, hydrophilic beads, formed by a three-dimensional network of dextran polymers. When these beads are placed on discharging burns, they absorb the exudate and swell, to form a gelatinous layer removing bacteria, degradation products, inflammatory mediators etc. from the wound surface. Our results indicate that it is a useful agent in burns of the hand, where it is easy to administer, prevents crust formation, reduces infection and allows maintenance of movement. Debrisan proved to be an effective treatment in all superficial and deep dermal burns of the hand and useful in already infected subdermal burns as a treatment before grafting. The healing time was shortened compared to open treatment and the pain in the hands of most patients rapidly decreased. The technique also offers an exceptional opportunity to perform studies on the content of burn exudate, since degradation and interaction are to a large extent prevented within the gel. |