Efficacy of enzymatic debridement of deeply burned hands
Section snippets
Materials and methods
Between 1985 and 1999, more than 300 burn patients were treated by Ds in the Soroka Medical Center burn unit within the framework of an open prospective study, approved by the institutional and national Helsinki Committees.
Burn depth was clinically assessed on admission to the ER by visual inspection, tactile inspection and by assessing blanching with pressure and capillary refill [20]. Burn wounds that were clinically assessed as deep dermal or full thickness, which according to our routine
Results
A total of 57 patients with 69 hand-burn wounds estimated as deep was analysed.
Other than pain, no enzymatic-debridement-related adverse events were recorded. Pain during Ds’ application was controlled by analgesia upon request. No anaesthesia was performed. The mean area of the hand-burn wounds which were initially estimated as deep was 1.4 ± 0.8% of total body surface area (TBSA).
Debridement has been initiated, on average, 0.9 days post-admission and completed in 4 h.
After debridement, 25 hands
Discussion
A previous study has demonstrated that often the excised burn eschar contains viable tissue: microscopically unaltered normal deep dermis, unaltered dermal collagen fibres and transected normal capillaries [24].
All hand-burn wounds treated in this study would have undergone tangential excision and grafting, if treated according to current state-of-the-art clinical practice.
Enzymatic debridement decreased both the number of patients with burns who eventuated in an operative procedure and the
Financial disclosure
The study was initiated in 1983 in the Soroka Burn Unit at the request of Drs. Klein and Houck who donated the Debridase enzyme. In 1992 GMP material for the study was produced and donated by Biotechnology General Ltd. Israel (BTG Ltd.). Since January 2002, Lior Rosenberg (LR) – one of the authors, is also the Chief Medical Director of MediWound Ltd. that produces the new improved Debridase preparation under the name of “Debrase”. LR did not have any financial interests in the company at the
Acknowledgements
Since January 2002, Lior Rosenberg is also the Chief Medical Director of MediWound Ltd. that produces the Debridase preparation under the name of ‘Debrase’. LR did not have any financial interests in the company at the time of the study (1984–1999).
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