Burn Debridement: Are We Optimizing Outcomes?

Early surgical debridement of nonviable tissue within 48 hours of burn injury is the standard of care (SOC) for burns extending into and beyond the deep dermis. Early debridement has been reported to reduce infection and complication rates, shorten hospital stays, and improve burn wound healing compared with delayed debridement of these burns.1 However, surgical debridement challenges patients with considerable pain, blood and heat loss, and poor differentiation between viable and dead tissue resulting in unnecessary excision of healthy tissue.2 Alternative debridement interventions, such as larval, enzymatic, hydrosurgical, or autolytic, have improved outcomes of chronic necrotic wounds3,4 and may offer ways to spare healthy tissue and minimize the recognized challenges of surgical debridement in patients with deep dermal or full-thickness burns. This installment of Evidence Corner reviews recent research exploring hydrosurgical5 or bromelain-based enzyme6 interventions reported to improve burn debridement or repair beyond the current SOC.