Journal of plastic surgery and hand surgery
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J Plast Surg Hand Surg · Aug 2020
Enzymatic debridement of hands with deep burns: a single center experience in the treatment of 52 hands.
Background: Bromelain-based enzymatic debridement has been introduced as an alternative to surgical excision in deep partial thickness and full thickness burns. We aimed to analyze effectiveness and predictors of spontaneous epithelialization after enzymatic debridement of deep hand burns. Methods: All patients who received enzymatic debridement for deep partial thickness or full thickness burns of the hands at our institution in the last 5 years were identified. ⋯ The following 3 years, 5 out of 25 deep partial thickness burns received surgery after a median of 14 days. Conclusions: Enzymatic debridement is a useful tool in the treatment of burned hands but the decision-making and correct timing of operative intervention in deep partial thickness burns after debridement requires experience. In our cohort, spontaneous healing of deep partial thickness burns was best in patients with contact burns and less than 15% burn TBSA.