Selective Enzymatic Debridement For The Management Of Acute Upper Limb Burns

Area of Science:

• Surgery
• Dermatology
• Regenerative Medicine

Background:

• Upper limb burn treatment presents significant medical and surgical challenges.
• Traditional treatments often involve lengthy procedures and recovery times.
• Enzymatic escharolysis is an emerging technique for rapid burn wound management.

Purpose of the Study:

• To evaluate the efficacy of enzymatic escharolysis with NexoBrid® for upper limb burns.
• To assess treatment outcomes in a non-burn referral center setting.
• To compare enzymatic escharolysis with standard burn care protocols.

Main Methods:

• Retrospective analysis of 18 patients with upper limb burns treated between December 2016 and June 2018.
• Evaluation of wound healing time, hospitalization duration, and scar assessment using POSAS and DASH scores.
• Inclusion criteria: upper limb burns admitted within 36 hours.

Main Results:

• Mean total body surface area (TBSA) affected was 3%; 4 patients had circumferential burns.
• Mean POSAS score was 14, indicating moderate scarring.
• Mean DASH score improved from 21 at 6 months to 11 at final follow-up, showing functional recovery.

Conclusions:

• Enzymatic escharolysis is a rapid, selective, and effective treatment for upper limb burns.
• It facilitates early physiotherapy and yields satisfying functional results.
• Consideration of enzymatic escharolysis as a standard of care in non-burn referral centers is recommended.