Retrospective Study Comparing Efficacy of Enzymatic Debridement with Nexobrid with Traditional Treatment in Circular Deep Burns in Prevention of the Compartment Syndrome

Introduction

Deep circular burns may threaten viability of an extremity, among other reasons, as a consequence of the compartment syndrome caused by fluid leakage and the restriction of compartment expansion caused by a rigid eschar (1). The enzymatic debriding agent Nexobrid® allows for the performance of an early and selective debridement of burned tissues by the first evaluation of a burned patient (2). One of its most supported indications are circular deep burns, with the aim of preventing and also treating the compartment syndrome (3-5). 

Material and methods

A retrospective review of the medical records of 33 patients attended at the Great Burns Unit of the Hospital La Fe of Valencia, Spain, was performed. The review included patients suffering deep second-degree and third-degree circular burns caused by either scald, contact or flames, affecting lower or upper limbs, treated from January 2014 to January 2017.

Results           

33 patients were included in the study, from which 25 were managed with the traditional treatment, and 11 treated with the enzymatic debriding agent Nexobrid®. In the traditional treatment group, 11 scharotomies were performed, while the Nexobrid® group required none. This differences proved to be statistically significant (p<0.05).

Conclusions

According to the results of this study, the use of the enzymatic debriding agent Nexobrid® can avoid or reduce the need of the performance of scharotomies in patients suffering from circular deep burns affecting limbs, preventing the morbidity associated to this procedure.

References

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2. Rosenberg L, Krieger Y, Bogdanov-Berezovski A, Silberstein E, Shoham Y, Singer AJ. A novel rapid and selective enzymatic debridement agent for burn wound management: A multi-center RCT. Burns. 2014;40(3):466-74.

3. Schulz A, Perbix W, Shoham Y, Daali S, Charalampaki C, Fuchs PC, et al. Our initial learning curve in the enzymatic debridement of severely burned hands—Management and pit falls of initial treatments and our development of a post debridement wound treatment algorithm. Burns. 2017;43(2):326-36.

4. Krieger Y, Bogdanov-Berezovsky A, Gurfinkel R, Silberstein E, Sagi A, Rosenberg L. Efficacy of enzymatic debridement of deeply burned hands. Burns. 2012;38(1):108-12.

5. Krieger Y, Rosenberg L, Lapid O, Glesinger R, Bogdanov-Berezovsky A, Silberstein E, et al. Escharotomy using an enzymatic debridement agent for treating experimental burn-induced compartment syndrome in an animal model. J Trauma. 2005;58(6):1259-64.