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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Enzymatic Debridement for Hand Burns: Function and Quality of Life One Year After Trauma

Meeting Abstract

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  • presenting/speaker Tomke Cordts - BG Klinik Ludwigshafen, Hand, Plastic and Reconstructive Surgery, Burn Center, Ludwigshafen, Germany
  • Benjamin Ziegler - BG Klinik Ludwigshafen, Hand, Plastic and Reconstructive Surgery, Burn Center, Ludwigshafen, Germany
  • Yannick Diehm - BG Klinik Ludwigshafen, Hand, Plastic and Reconstructive Surgery, Burn Center, Ludwigshafen, Germany
  • Sebastian Fischer - BG Klinik Ludwigshafen, Hand, Plastic and Reconstructive Surgery, Burn Center, Ludwigshafen, Germany
  • Leila Harhaus - BG Klinik Ludwigshafen, Hand, Plastic and Reconstructive Surgery, Burn Center, Ludwigshafen, Germany
  • Ulrich Kneser - BG Klinik Ludwigshafen, Hand, Plastic and Reconstructive Surgery, Burn Center, Ludwigshafen, Germany

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-874

doi: 10.3205/19ifssh0410, urn:nbn:de:0183-19ifssh04109

Published: February 6, 2020

© 2020 Cordts et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Over the last years, Enzymatic Debridement has become an accepted alternative for the treatment of severe burns. A topical burn eschar removal by the proteolytic enzyme mix NexoBrid® has certain important advantages when compared to Standard of Care. Most notably, it allows for a selective debridement, conserving adjacent tissue. This appears to be especially beneficial in severe burns of the hands, where conventional, "sharp" nectrectomy by knife or blade is usually accompanied by extensive functional damage.

Methods: Patients that were admitted to our hospital and had received Enzymatic Debridement on at least one burned hand between 2016 and 2017 were reexamined in our outpatient clinic one year after trauma.

Range of Motion and grip strength were evaluated on both hands. Firmness and elasticity parameters were obtained by comparing scarred and unaffected skin by Cutometer® measurement. Patients were asked to complete DASH, SF-36 and the Ludwigshafen version of the Burn Specific Health Scale-Brief (BSHS-B) questionnaires to assess remaining functional deficits and present quality of life.

Results: As of today, 14 patients (9 male, 5 female) could be included in the study. Average TBSA was 12.6 %, 2.2 % TBSA were attributed to burns of the hands. As assumed, grip strength and range of motion were reduced on burned extremities. Firmness was increased, most elasticity parameters were decreased in the originally injured area when compared to unaffected skin. DASH showed significant functional impairment when compared to the average population, scores for emotional and psychological well-being were lower in the SF-36 questionnaire. However, BSHS-B scores were equivalent to those of a reference collective of burn patients.

Conclusions: One year after trauma, patients with hand burns that were treated with Enzymatic Debridement still showed significant morbidity. Functional and psychological impairments were higher than in the average population but comparable to values observed in a reference collective of burn patients. Further examinations in the next couple of weeks, that will gain more results from a larger number of patients as well as a control group. are needed to clarify the current conclusions.