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Coagulation side effects of enzymatic debridement in burned patients

Pfister, Pablo; Wendel Garcia, Pedro David; Kim, Bong-Sung; Schuepbach, Reto A; Steiger, Peter; Camen, Giovanni; Buehler, Philipp Karl (2023). Coagulation side effects of enzymatic debridement in burned patients. Burns, 49(6):1272-1281.

Abstract

Objectives: Bromelain-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.

Methods: Between 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.

Results: In 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).

Conclusion: Enzymatic debridement in burned patients does not appear to increase the risk of coagulation abnormalities compared with the regular surgical approach.

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Intensive Care Medicine
04 Faculty of Medicine > University Hospital Zurich > Clinic for Reconstructive Surgery
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Critical Care and Intensive Care Medicine, Emergency Medicine, General Medicine, Surgery
Language:English
Date:1 September 2023
Deposited On:15 Dec 2022 09:47
Last Modified:28 Oct 2024 02:39
Publisher:Elsevier
ISSN:0305-4179
OA Status:Hybrid
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.burns.2022.11.008
Related URLs:https://www.zora.uzh.ch/id/eprint/232355/
PubMed ID:36566096
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  • Licence: Creative Commons: Attribution 4.0 International (CC BY 4.0)

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