• Pablo Pfister, Pedro David Garcia Wendel, Bong Sung Kim, Reto Andreas Schuepbach, Peter Steiger, Giovanni Camen, and Philipp Karl Buehler.
• Institute of intensive Care Medicine, University Hospital of Zurich, Zurich, Switzerland.
• Burns. 2023 Sep 1; 49 (6): 127212811272-1281.

ObjectivesBromelain-based enzymatic debridement has emerged as a valuable option to the standard surgical intervention for debridement in burn injuries. Adverse effects on coagulation parameters after enzymatic debridement have been described. The purpose of this study was to compare the effect of enzymatic and surgical debridement on coagulation.MethodsBetween 03/2017 and 02/2021 patients with burn injuries with a total body surface area (TBSA) ≥ 1% were included in the study. Patients were categorized into two groups: the surgically debrided group and the enzymatically debrided group. Coagulation parameters were assessed daily for the first seven days of hospitalization.ResultsIn total 132 patients with a mean TBSA of 17% were included in this study, of which 66 received enzymatic debridement and 66 received regular surgical-debridement. Patients receiving enzymatic debridement presented significantly higher factor-V concentration values over the first seven days after admission (p = <0.01). Regarding coagulation parameters, we found no difference in INR-, aPTT-, fibrinogen-, factor-XIII- and thrombocyte-concentrations over the first seven days (p = >0.05).ConclusionEnzymatic debridement in burned patients does not appear to increase the risk of coagulation abnormalities compared with the regular surgical approach.Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.

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