SUMMARY
The basic principle in the treatment of deep burns is to remove necrotic tissue from the burn wound as soon as possible. Debridement of deep burns is standardly performed surgically, most commonly by tangential necrectomy. After necrosectomy, the burned areas must be finally covered with the patient‘s own skin graft. Although surgical debridement is highly effective, it is non-selective and is associated with large patient blood loss. The disadvantages of the standard therapy had led to the development of less invasive and more selective method of burn eschar removal.

The basic principle of enzymatic debridement is to accelerate the decomposition of necrotic tissue using exogenous enzymes. A new bromelain-based enzyme mixture that removes necrotic tissue from deep burns quickly and selectively is now available. Thanks to its high-selective eschar removal with the preservation of vital tissues it is known as the minimal invasive modality in the treatment of deep burns.
The current clinical experience with the novel enzyme mixture has shown several advantages compared to tangential necrosectomy. The application of the new enzymatic product does not require general anesthesia, is not accompanied by significant blood loss, reduces the number of surgical procedures and the need for skin autotransplantation. Considering the numerous advantages, the enzymatic debridement could become a new method of choice in the treatment of deep burns.
Key words: burns, necrosectomy, necrolysis, enzymatic debridement, bromelain.

Lek Obz, 2020, 69 (10): 352-358

Nikola FERANČÍKOVÁ, Peter ZÁHOREC, Ján KOLLER

Klinika popálenín a rekonštrukčnej chirurgie LF UK a UNB, Ružinov, Bratislava, prednosta prof. MUDr. J. Koller, PhD.

Nikola FERANČÍKOVÁ, Peter ZÁHOREC, Ján KOLLER: Minimally invasive enzymatic necrolysis of deep burns. Lek Obz, 2020, 69 (10): 352-358