Eschar removal by bromelain based enzymatic debridement (Nexobrid ®) in burns: An European consensus

Publication date: Available online 13 October 2017 Source:Burns Author(s): Christoph Hirche, Antonella Citterio, Henk Hoeksema, Ján Koller, Martina Lehner, José Ramón Martinez, Stan Monstrey, Alexandra Murray, Jan A. Plock, Frank Sander, Alexandra Schulz, Benjamin Ziegler, Ulrich Kneser Early debridement and/or eschar removal is regarded as a significant step in the treatment of deep partial and full thickness burns. It aims to control wound bioburden and allows early wound closure by conservative treatment or skin grafting. Preservation of viable dermis accompanied by early wound closure, is regarded as a necessary step to reduce scar related complication, e.g. functional limitations and/or unaesthetic scar formation. Aside from the classical techniques of surgical excision as tangential excision for eschar removal, hydro-surgery, maggot therapy, laser, enzymatic debridement have been described as additional techniques in the burn surgeon’s armamentarium. It is widely accepted that early eschar removal within 72h improves the outcome of burn wound treatment by reducing bacterial wound colonization, infection and length of hospital stay. In contrast, the right technique for eschar removal is still a matter of debate. There is increasing evidence that enzymatic debridement is a powerful tool to remove eschar in burn wounds, reducing blood loss, the need for autologous skin grafting and the number of wounds requiring surgical excision. In order to assess the...

Source: Burns - October 13, 2017 Category: Dermatology Source Type: research