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. 2022 Aug 17;11(16):4800.
doi: 10.3390/jcm11164800.

Preliminary Single-Center Experience of Bromelain-Based Eschar Removal in Children with Mixed Deep Dermal and Full Thickness Burns

Tomasz Korzeniowski  1   2 , Ewelina Grywalska  3 , Jerzy Strużyna  2   4 , Magdalena Bugaj-Tobiasz  2 , Agnieszka Surowiecka  2 , Izabela Korona-Głowniak  5 , Magdalena Staśkiewicz  6 , Kamil Torres  1
Affiliations

Preliminary Single-Center Experience of Bromelain-Based Eschar Removal in Children with Mixed Deep Dermal and Full Thickness Burns

Tomasz Korzeniowski et al. J Clin Med. .

Abstract

Introduction: Early eschar removal is the standard management of burns. The goal is to remove all of the necrotic tissue and render the wound suitable for healing or skin grafting. The enzymatic debridement of burn wounds allows for minimally invasive removal of burn eschar. The aim of the study was to describe and compare the demographic characteristics, surgical treatment and outcomes of patients treated with Nexobrid® with patients who had standard surgical excision.

Material and methods: A retrospective review was conducted on children who underwent enzymatic debridement. The study group was compared with children treated with the standard of care (SoC).

Results: Twelve children (mean age 8 years, range 3 to 15 years) with mixed deep dermal and full thickness burn wounds were treated with Nexobrid®. The mean size of the burns was 29% TBSA. The median percentage TBSA debrided using Nexobrid® was 15% (range 2-27%). In a clinical assessment, enzymatic debridement was effective in removing dead tissue in a single application. No adverse reaction to Nexobrid® and serious complications after enzymatic procedure were recorded in the study group. The estimated relative risk of the need for reconstructive procedures decreases 3.5 times for the study group (RR 3.5, 95%CI 0.9-13.5, p = 0.089).

Conclusion: The bromelain-based enzymatic method offers a good and safe debridement option to improve the treatment and life quality of children with severe burns. The main outcome of interest was the number of reconstructive procedures due to scar contractures, which was reduced in the group treated enzymatically compared to the SoC-treated children.

Keywords: burns; enzymatic debridement; wound healing.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Burn on arrival.
Figure 2
Figure 2
Nexobrid® application.
Figure 3
Figure 3
Result of enzymatic debridement.
Figure 4
Figure 4
Final result (on discharge from hospital).
Figure 5
Figure 5
Treatment algorithm.
See this image and copyright information in PMC

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References

    1. Xiao-Wu W., Herndon D.N., Spies M., Sanford A.P., Wolf S.E. Effects of delayed wound excision and grafting in severely burned children. Arch. Surg. 2002;137:1049–1054. doi: 10.1001/archsurg.137.9.1049. - DOI - PubMed
    1. Pruitt B.A., Jr., McManus A.T., Kim S.H., Goodwin C.W. Burn wound infections: Current status. World J. Surg. 1998;22:135–145. - PubMed
    1. Williams F.N., Lee J.O. Pediatric burn infection. Surg. Infect. (Larchmt) 2021;22:54–57. doi: 10.1089/sur.2020.218. - DOI - PubMed
    1. Daugherty T.H.F., Ross A., Neumeister M.W. Surgical Excision of Burn Wounds. Clin. Plast. Surg. 2017;44:619–625. doi: 10.1016/j.cps.2017.02.018. - DOI - PubMed
    1. Tompkins R.G., Remensnyder J.P., Burke J.F., Tompkins D.M., Hilton J.F., Schoenfeld D.A., Behringer G.E., Bondoc C.C., Briggs S.E., Quinby W.C., Jr. Significant reductions in mortality for children with burn injuries through the use of prompt eschar excision. Ann. Surg. 1988;208:577–585. doi: 10.1097/00000658-198811000-00006. - DOI - PMC - PubMed

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