gms | German Medical Science

Introduction: Surgical methods of deep burns excision became very popular in the last few decades. Less aggressive and more selective option for eschar removal can be achieved by the use of proteolytic enzymes.

With the discovery of more effective enzymes more rapid and selective removal of necrotic tissues could be achieved.

Methods: The Bratislava Burn Department participated in two multicenter clinical studies focused on efficacy and safety of enzymatic debridement of acute deep burns by a new family of proteolytic enzymes derived from pineapple stems under the name of Debrase Gel Dressing^® (DGD). DGD debridement was compared to standard of care (SOC) in the center. The primary endpoint was the percentage of treated wound needed to be excised secondarily. The secondary endpoint was the time to complete wound closure and percentage of autografting of the treated wound. Safety parameters included SAE, vital signs, laboratory tests, numbers of blood transfusions, occurrence of wound infection, pain, local adverse events and graft loss.

Results: Only acute burns of duration less than 72 hours could be treated. 22 patients altogether were enrolled in the two studies (15 and 7, respectively). In all patients receiving DGD more than 90% debridement was achieved within 4 hours post application. No serious adverse events or reactions related to DGD use occurred.

Various modalities were used for treatment of the debrided wounds. They included application of porcine skin xenografts, human skin allografts, cultured allogenic keratinocytes, skin autografts. Our experiences with these treatment methods related to the final outcome are presented and discussed.

Conclusions: Enzymatic debridement by DGD proved to be innovative, rapid, effective and safe method for early selective debridement of acute deep burns. The 2^nd multicenter clinical study is still going on.