Evaluation of burned hand function after enzymatic debridement

Area of Science:

• Burns Management
• Regenerative Medicine
• Wound Healing

Background:

• Hand burns frequently lead to long-term functional impairment.
• Enzymatic debridement (ED) offers selective removal of necrotic tissue, preserving viable dermis.
• ED facilitates accurate depth assessment and promotes wound re-epithelialization, potentially reducing skin grafting needs.

Purpose of the Study:

• To evaluate the efficacy of enzymatic debridement (ED) with bromelain for deep partial-thickness hand burns.
• To assess functional recovery, quality of life, and scar quality following bromelain ED treatment.
• To determine the long-term outcomes of this treatment modality.

Main Methods:

• A prospective study enrolled patients with deep partial-thickness hand burns treated with bromelain ED.
• Hand function was assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) and Michigan Hand Outcomes Questionnaire (MHOQ).
• Range of motion (goniometer) and scar quality (Vancouver Scar Scale - VSS) were also evaluated.

Main Results:

• Bromelain enabled early debridement in 73.6% of cases within 24 hours.
• At 3 months, mean DASH and MHOQ scores were 2.35 and 97.9%, indicating significant functional recovery.
• Excellent joint range of motion and low VSS scores (mean 2.87) were observed, with sustained results at over 1 year follow-up.

Conclusions:

• Enzymatic debridement with bromelain is a safe and effective treatment for deep partial-thickness hand burns.
• The treatment leads to rapid wound healing, complete restoration of hand function, and improved quality of life.
• Bromelain ED provides favorable scar outcomes and normalizes function within 3 months, with sustained results post-treatment.