Cherubino M, Valdatta L, Baroni T, Pellegatta I, Tamborini F, Garutti L, Di Summa P, Adani R
Division of Plastic and Reconstructive Surgery, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
Microsurgery and Lymphatic Surgery Research Center, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
Ann Burns Fire Disasters. 2021 Dec 31;34(4):328-333.
Upper limb burn treatment represents a major medical and surgical challenge. Enzymatic escharolysis is a rather new technique to treat thermal burns in an easy and rapid way, as an alternative to the standard of care. The aim of the study was to investigate and describe the efficacy of treatment of upper limb burns with NexoBrid® in a non-burn referral center. All patients suffering from upper limb burns and admitted within 36 hours to the Hand and Microsurgery Unit of the ASST Sette Laghi from December 2016 to June 2018 were enrolled in the study. A retrospective analysis was performed, evaluating time to wound healing, time of hospitalization, and scar aesthetic appearance with patient and observer scar assessment scale (POSAS) and disabilities of the arm, shoulder and hand score (DASH). A total of 18 patients with burns involving the upper limb from December 2016 to June 2018 were treated. The mean TBSA% involved was 3%; 4 out of 18 patients suffered circumferential burns. The mean POSAS score was 14; the mean DASH score at 6-month follow up was 21, while it reduced to 11 at the last follow up visit. Enzymatic escharolysis is a novel, rapid and selective treatment option that allows early physiotherapy with overall satisfying functional results. We believe that enzymatic escharolysis should be considered, in most cases, as the standard of care in the treatment of upper limb burn wounds in non-burn referral centers.
上肢烧伤治疗是一项重大的医学和外科挑战。酶解清创术是一种相当新的技术，可作为标准治疗方法的替代方案，以简便快速的方式治疗热烧伤。本研究的目的是在一家非烧伤转诊中心调查并描述使用NexoBrid®治疗上肢烧伤的疗效。2016年12月至2018年6月期间，所有上肢烧伤且在36小时内被收治到ASST Sette Laghi手部显微外科的患者均纳入本研究。进行了回顾性分析，使用患者和观察者瘢痕评估量表（POSAS）以及手臂、肩部和手部功能障碍评分（DASH）评估伤口愈合时间、住院时间和瘢痕美观外观。2016年12月至2018年6月期间，共有18例上肢烧伤患者接受了治疗。平均烧伤总面积百分比为3%；18例患者中有4例为环形烧伤。平均POSAS评分为14分；6个月随访时的平均DASH评分为21分，而在最后一次随访时降至11分。酶解清创术是一种新颖、快速且具有选择性的治疗选择，可实现早期物理治疗，总体功能结果令人满意。我们认为，在大多数情况下，酶解清创术应被视为非烧伤转诊中心治疗上肢烧伤创面的标准治疗方法。
