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Delayed enzymatic debridement in severe burns: Proof of concept

机译：严重烧伤的延迟酶促创新：概念证明

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Introduction Enzymatic debridement (ED) is a novel powerful therapy for debridement of severe burns. Standard ED is usually performed within 72?h after injury following a presoaking phase. Little evidence exists on the effectiveness of ED later than 72?h after trauma. In this retrospective study, we compared outcomes of burn patients treated within versus later than 72?h after injury. Patients and Methods 110 patients with severe burns treated with ED between 2016 and 2020 were evaluated. Patients treated later than 72?h after trauma were identified and matched to a control group treated within 72?h. Matching criteria included age, area treated with ED, and localization of ED. Exclusion criteria were abbreviated burn severity index (ABSI)?greater than?12 and death within the first 10?days after burn injury. Primary outcomes were time to full epithelialization and number of secondary surgical interventions. Results 16 patients (11 female, 5 male) matched the inclusion criteria and were assigned to the late treatment group. Mean age was 54.0?±?19.0?years, the?=?and mean ABSI score 6.3?±?3.2. 16 matched patients were assigned to the early ED group. Secondary surgical procedures were performed in 62.5% of cases in both groups with a mean of 1.7 (late treatment) vs. 2.2 (control; p?=?0.29) secondary procedures in each group, respectively. No significant difference between groups regarding time to complete epithelialization (28.2?days vs. 27.3?days, p?=?0.45) was observed. Infection rate was higher (18.8% vs. 6.3%, p?=?0.28) in the delayed group. Conclusion Delayed ED is a feasible procedure as part of personalized care in burn surgery. In our retrospective study, we could not identify r safety issues except a slightly higher infection rate. This may however be attributed to delayed initiation of burn treatment itself.
机译：引言酶促作业（ED）是一种新的强烈治疗，用于严重灼伤的清新。标准ED通常在预取阶段后损伤后在72℃内进行。在创伤后，eD的有效性很少存在少数证据。在这项回顾性研究中，我们在损伤后比较晚于72℃的烧伤患者的结果比较了烧伤患者。患者和方法110患者在2016年和2020年之间进行编辑治疗的严重烧伤患者。鉴定创伤后晚72℃治疗的患者并与在72μmE中处理的对照组匹配并匹配。匹配标准包括年龄，用ED处理的区域，ED的本地化。排除标准缩写烧伤严重程度指数（ABSI）？大于？12和前10天内的死亡，烧伤后的一天。主要结果是时间达到全上皮化和次要手术干预次数。结果16名患者（11名女性，5名男性）匹配纳入标准，并分配给晚治疗组。平均年龄为54.0？±19.0？年，？=？和平均得分6.3？±3.2。将16名匹配患者分配给早期的ED组。二次外科手术在两组的62.5％的病例中进行，其两组的平均值为1.7（晚期）与2.2（对照; P？= 0.29）分别在每组中的二级程序。关于完全上皮的时间（28.2天与27.3）之间没有显着差异，观察到观察到。延迟组中感染率更高（18.8％vs.6.3％，p？= 0.28）。结论延迟ED是一种可行的程序，作为烧伤手术中的个性化护理的一部分。在我们的回顾性研究中，除了稍高的感染率外，我们无法识别R安全问题。然而，这可能归因于延迟烧伤治疗本身的启动。

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