Here - EWMA 2013

POSTER: ACUTE WOUNDS
Poster: Acute Wounds
P 196
DEEPLY BURNED HANDS TREATED BY FAST BROMELAIN BASED ENZYMATIC
DEBRIDEMENT: COMPARISON TO SOC
Yaron Shoham 1 , Yuval Krieger 1 , Alexander Bogdanov-Berezovsky 1 , Eldad Silberstein 1 ,
Adam Singer 2
1 Department of Plastic and Reconstructive Surgery and Burn Unit, Soroka University
Medical Center (Be’er Sheva, Israel);
2 Department of Emergency Medicine, Stony Brook University (Stony Brook, New York,
United States).
Aim: To investigate the role of Bromelain debriding* (BD) agent in treating deeply
burned hands.
Methods: Following an in-vivo porcine circumferential burn model, a prospective,
randomized controlled Phase III trial (181 patients) and a retrospective analysis of 154
files of a previous clinical study were used to study BD efficacy in debriding and
resolving/preventing burn induced compartment syndrome (BICS). The implication of
such an enzymatic debrider on surgical burden in deep hand burns care, compared to a
control group of burned hands treated by standard of care (SOC) were assessed by
endpoints of incidence and wound area surgically debrided and autografted,
escharotomy incidence as well as before and after interstitial/ compartment pressures.
Results: Data of 130 BD and 41 SOC treated burned hands in two studies as well as 20
porcine circumferential burns demonstrated a statistically significant decrease in post BD
application pressure. No escharotomy was performed in all BD treated hands
(0/130=0%) vs. 4 hands (4/41=9.7%), escharotomized in the SOC arm. A statistically
significant decrease in time to complete debridement, excisional and grafting surgery
and comparable scarring compared to SOC was found.
Conclusion: Use of BD to treat deeply burned hands significantly decreased the time to
complete debridement and surgical load (excisional and autografting surgery), offering
more preserved viable dermis for epithelialization. Statistically significant BICS and
interstitial pressure reduction/preventing has been observed both in animal and human
studies.
* BD is distributed as NexoBrid (previously published as Debrase, Debridase ® ) by Mediwound LTD
P 197
NEGATIVE PRESSURE WOUND THERAPY FOR TREATMENT OF ACUTE
PURULENT SOFT TISSUE DISEASES
Poster: Acute Wounds
Alexander Ermolov 1 , Vladimir Obolenskiy 2 , Grigoriy Rodoman 1
1 RNRMU (Moscow, Russia);
2 City Hospital # 13 (Moscow, Russia).
Aim: To assess the efficacy of negative pressure wound therapy (NPWT) in treatment of
soft tissues acute purulent diseases (STAPD).
Methods: Analysis of treatment outcomes of 31 patients with extensive phlegmons and
abscesses was performed. On admission all patients underwent incision and drainage of
purulent focusand received empirical antibiotic therapy. On day 3 NPWT was used for
the wound (experimental group: 8 males, 9 females, mean age was 51.5±4.5 years,
mean baseline wound volume 315.2±70.2 cm3, bacterial contamination level was 107),
dressing was changed every 3-4 days, or dressings with traditional topical antiseptics
were used (control: 6/8; 49.1±4.5; 315.4±91.4 cm3; 107), followed by daily dressing
change. Following wound decontamination and formation of granulation tissue,
secondary sutures were applied.
Results: On day 7 in the experimental group, the mean wound volume was 96.5 cm3
with bacterial contamination level 102, while in the control group those were 162.1 cm3
and 105, respectively. Time to applying secondary suturesin patients of the experimental
group was 10.2±1.1 days,while in the control group it was 18.6±0.6 (sutures were
applied in 3 patients only). Mean duration of hospital stay was 16.0±1.7 days and
21.6±1.9 days, respectively. Mean cost of treatment was EUR 1593.93 and EUR
1822.14 per patient, respectively.
Conclusion: NPWT isa clinically beneficial and cost effective method of treatment of
STAPD.
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
127