Evaluación de tiempos quirúrgicos y transfusiones en pacientes quemados tratados con desbridamiento enzimático.

Background and Objective. During the last years, results have been published demonstrating fast, efficient and specific enzymatic debridement of burned tissues with the use of a concentrate of proteolytic enzymes enriched with bromelain (Nexobrid®, Mediwound, Germany). In this study we compare the use of Nexobrid® against a Control Group with standard treatment, in order to evaluate; the number of surgical procedures performed, the colonization of the surgical bed, the need for scarotomies, as well as the number of transfusions of the treated patients according to the total burned surface area (TBSA). Methods. We conduct a retrospective study evaluating 65 patients (mean age 46.87 years) treated with Nexobrid® between September 2015 and December 2016. We compare this population with a control group of 177 patients (mean age 48.24 years) treated with tangential excision from January to December 2014. The Control Group was homogeneous to Nexobrid® Group. Both groups were stratified according to their TBSA in 2 groups: more or less than 15%. Results. We found lesser number of days from burn and hospital admission to the first debridement for the Nexobrid® Group regardless of the burned body surface. Statistically significant differences were obtained for the number of surgeries (p <0.01) in the subgroup with <15% TBSA. We evaluated the colonization without obtaining statistically significant differences between the groups. The number of scarotomies carried out in the Nexobrid® Group was significantly lower than in the Control Group when comparing the populations with ≥15% TSBA. The transfusion requirements were lower in the Nexobrid® Group compared to the Control Group in patients with ≥15% TBSA (p <0.05). Conclusions. The use of Nexobrid® allows reducing the number of surgeries and the time elapsed to first debridement without increasing the rate of colonization when compared to the Control Group. Early enzymatic debridement reduces the need for scarotomies in =15% TBSA patients. The use of Nexobrid ® reduces the need for blood transfusion in patients with ≥15% TBSA. [ABSTRACT FROM AUTHOR]