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Ann Burns Fire Disasters. 2017 Sep 30;30(3):198-204.

Bromelain-based enzymatic debridement and minimal invasive modality (mim) care of deeply burned hands.

Author information

1
Department of Plastic Surgery and Burn Unit, Soroka Medical Center, The Ben-Gurion University of the Negev, Beer Sheva, Israel.
2
Orthopedic Department, Emek Medical Center, Afula / Faculty of Medicine, Technion, Haifa, Israel.
3
Klinik für Plastische Chirurgie, Handchirurgie - Schwerbrandverletztenzentrum - Krankenhaus Merheim, Lehrstuhl für Plastische Chirurgie der Universität Witten/Herdecke, Köln, Germany.
4
Cleft Lip & Palate & Craniofacial Deformities Unite, Department of Plastic Surgery, Meir Hospital Kfar Saba, Israel / MediWound Ltd. Israel.
5
Department of Emergency Medicine, Stony Brook University, Stony Brook, NY, USA.

Abstract

in English, French

The objective was to critically review the data and assess the implications of NexoBrid [NexoBrid-NXB formerly Debrase Gel Dressing-DGD]a in the special field of deep hand burns. Detailed analysis of endpoints in the treatment of hand burn patients was conducted as part of a multi-center, open label, randomized, controlled two-arm study to evaluate the safety and efficacy of NXB enzymatic debridement, comparing it to the current standard of care (SOC). These results were compared to a large cohort of patients treated with NXB in a previous, single arm study. Thirty-one burned hands were treated with NXB and 41 hand burns were in the SOC group. In the NXB group, 4 out of 31 hand burns (12.9%) required some excisional debridement compared to 29 out of the 41 (70.7%) in the SOC group (p<0.0001). Mean percentage of burn wound area excised in the NXB group was 4.4 ± 13.1% compared to 52.0 ± 41.4% in the SOC group (p<0.0001). None of the NXB-treated hands required escharotomy compared to 4 out of the 41 (9.7%) in the SOC group. NXB enzymatic debridement demonstrated a statistically significant reduction in burn wound excision and auto-grafting compared to SOC, and seems to prevent the need for emergency escharotomy. a DGD is produced by MediWound and distributed under the name NexoBrid®.

KEYWORDS:

MIM,; burns; enzymatic debridement; enzymatic escharotomy; enzymatic surgery; eschar removal; hands; minimally invasive modality of burn care

PMID:
29849523
PMCID:
PMC5946757

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