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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Does enzymatic debridement allow us to perform conservative treatment on clinically deep hand burns? A retrospective review

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  • presenting/speaker Danilo Antonio Rivas Nicolls - Vall d'Hebron University Hospital, Barcelona, Spain
  • Irene Gallardo Calero - Vall d'Hebron University Hospital, Barcelona, Spain
  • Jordi Aguilera Saez - Vall d'Hebron University Hospital, Barcelona, Spain
  • Jordi Serracanta Domenech - Vall d'Hebron University Hospital, Barcelona, Spain
  • Pablo Gomez Morell - Vall d'Hebron University Hospital, Barcelona, Spain
  • Ricard Palao Domenech - Vall d'Hebron University Hospital, Barcelona, Spain
  • Joan Pere Barret Nerin - Vall d'Hebron University Hospital, Barcelona, Spain

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-623

doi: 10.3205/19ifssh0021, urn:nbn:de:0183-19ifssh00213

Published: February 6, 2020

© 2020 Rivas Nicolls et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: The hands are one of the main locations of burns. In deep second- and third-degree burns, the gold standard of treatment is surgical debridement and subsequent coverage, which can result in suboptimal esthetic and functional results. The aim of our study is to assess whether treatment by initial enzymatic debridement (NexoBridŽ) of deep second-degree burns and third-degree burns prevents the need for surgery.

Methods: We carried out a retrospective study of 53 hands with deep burns treated in our center from May 2015 to December 2016. Two experts evaluated the initial photographs of the burns and classified them as surgical or nonsurgical (interobserver kappa statistic 0.83). These assessments were compared with the actual need for surgery for each hand.

Results and Conclusions: Sixteen of the 32 (50%) hands that the experts considered surgical spontaneously epithelialized. Four of the 17 hands (23.5%) that were not considered surgical required a split-thickness skin graft for healing. Enzymatic debridement helps to preserve viable tissue, which reduces the number and extension of surgical interventions, thus favoring better results.