What is helpful in deciding what and when to operate after enzymatic debridement.

Burns ◽  
2022 ◽  
Author(s):  
Karel E.Y. Claes ◽  
Ignace De Decker ◽  
Stan Monstrey ◽  
Yaron Shoham ◽  
Tom Vyncke ◽  
...  
Burns ◽  
2021 ◽  
Author(s):  
Karel E.Y. Claes ◽  
Sarah Amar ◽  
Henk Hoeksema ◽  
Kornhaber Rachel ◽  
Alette de Jong ◽  
...  

1954 ◽  
Vol 27 (1) ◽  
pp. 45-54
Author(s):  
Seymour M. Farber ◽  
R. Daniel Gorman ◽  
David A. Wood ◽  
Orville F. Grimes ◽  
Samuel L. Pharr

Trauma ◽  
2021 ◽  
pp. 146040862110025
Author(s):  
John Kiely ◽  
Ibrahim Natalwala ◽  
Joseph Stallard ◽  
Orla Austin ◽  
Umair Anwar ◽  
...  

Bromelain-based enzymatic debridement (ED) is a topical treatment that is growing in popularity for the non-surgical management of burn wounds. Although initially used for small injuries, experience has grown in using it for burns >15% Total Burns Surface Area (TBSA). A household explosion resulted in burns to multiple patients, with four requiring burn wound debridement. This case report demonstrates their management using ED. Four adult male patients were treated with ED, mean age 38.4 years. Their injuries ranged from 5–24% TBSA (mean 14.9%), with a high proportion of intermediate-deep dermal injury to their faces and limbs. Our centre has performed enzymatic debridement since 2016 and all senior burns surgeons and burns intensive care specialists in the team are experienced in its use. We perform enzymatic debridement using Nexobrid™ (Mediwound Ltd., Israel). Three patients were managed on a single theatre list, using ED for their burns at 19, 16 and 23 hours post-injury. One patient had ED of his injuries on intensive care at 18 hours. Patients with >15% TBSA were treated in a critical care setting with goal directed fluid therapy. Through the use of enzymatic debridement we were able to achieve burn debridement for four patients in under 24 hours. While not a true mass casualty incident, our experience suggests that for an appropriately resourced service it is likely to have advantages in this scenario. We suggest that burns services regularly using this technique consider inclusion into mass casualty protocols, with training to staff to enable provision in such an incident.


2021 ◽  
Author(s):  
Angela Tecuceanu ◽  
Teodor Stamate ◽  
Dan Cristian Moraru ◽  
Dobre Costel ◽  
Ilan Marcovici ◽  
...  

Author(s):  
Marc Daniels ◽  
Jan Philipp Stromps ◽  
Wolfram Heitzmann ◽  
Jennifer Schiefer ◽  
Paul Christian Fuchs ◽  
...  

Abstract There is an increased risk for burn injuries associated with home oxygen therapy of patients with chronic obstructive pulmonary disease since 10 to 50 % of these patients continue to smoke. Enzymatic eschar removal of facial burns is gaining popularity but intubation of this specific patient group often leads to prolonged weaning and can require tracheostomy. This study dealt with the question if enzymatic debridement in these patients can also be performed in analgosedation. A selective review of the literature regarding burn trauma associated with home oxygen use in patients with COPD was performed, as well as a retrospective analysis of all patients with burn injuries associated with home oxygen use and chronic obstructive pulmonary disease that were admitted to the study clinic. In the literature 1746 patients with burns associated with home oxygen use are described, but none of them received enzymatic debridement. In this study seventeen patients were included. All three patients in this study with facial full-thickness burn injuries received enzymatic debridement. The mortality rate in this cohort was 17.6 % (3/17). Up to date, there is limited experience performing regional anesthesia debridement in patients with COPD. This is the first manuscript describing the use of enzymatic debridement in patients with COPD and home oxygen therapy. We could confirm other studies that intubation of these patients leads to prolonged ventilation hours and increases the probability for poor prognosis. Therefore, we described the treatment of enzymatic debridement in analgosedation without intubation.


2018 ◽  
Vol 39 (suppl_1) ◽  
pp. S196-S197
Author(s):  
M Harats ◽  
R A Kornhaber ◽  
G Trodler ◽  
Y Shoham ◽  
J Haik

2017 ◽  
Vol 61 (1) ◽  
pp. 38-42 ◽  
Author(s):  
L. Hamilton ◽  
M. Kožár

Abstract Skin wounds are a common presentation in small animal practice. These wounds may be acute or chronic with a complicated healing process. An important aspect of the healing of wounds is debridement which may be carried out by surgical, autolytic, mechanical or enzymatic methods. The debridement method is chosen according to the individual skin defect and influenced by factors such as wound size and location, the age of the wound, and the presence of infection or exudate. Enzymatic debridement is a method that is not commonly used in veterinary practice, and involves the use of enzyme preparations to remove necrotic tissue from a wound. The aim of this study was to investigate the effects of the enzymatic ointment collagenase as a method of debridement, and its effect on the macroscopic appearance of chronic skin wounds in cats and dogs. We observed that the application of Iruxol Mono directly to the wound changes the progress of the healing process, with no obvious adverse effects. The time of healing of chronic wounds was decreased and healthy granulation tissue was developed within a couple of days after application of the ointment. Enzymatic debridement appears to be a promising method of debridement for use in chronic wounds, and should be considered in cases where more conventional methods of debridement are ineffective or unsuitable.


2018 ◽  
Vol 15 (5) ◽  
pp. 769-775 ◽  
Author(s):  
Yaron Shoham ◽  
Yuval Krieger ◽  
Eran Tamir ◽  
Eldad Silberstein ◽  
Alexander Bogdanov-Berezovsky ◽  
...  

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