Enzymatic Debridement in Severe Burn COVID-19 Patients: A Case Series.

Autor: Coletta F; Emergency and Acceptance Department, Anesthesia, Emergency and Burn Intensive Care Unit, 'A.O.R.N. A. Cardarelli', Naples, Italy., Sala C; Emergency and Acceptance Department, Anesthesia, Emergency and Burn Intensive Care Unit, 'A.O.R.N. A. Cardarelli', Naples, Italy., De Marco GP; Covid 19 Intensive Care Unit, 'A.O.R.N. A. Cardarelli', Naples, Italy., Mataro I; Department of Burn Unit and Plastic Surgery, 'A.O.R.N. A. Cardarelli', Naples, Italy., Petroccione C; Department of Burn Unit and Plastic Surgery, 'A.O.R.N. A. Cardarelli', Naples, Italy., Bonagura P; Covid 19 Intensive Care Unit, 'A.O.R.N. A. Cardarelli', Naples, Italy., Pirolli R; Anesthesia, Emergency and Intensive Care Unit, ASL Caserta, PO San Giuseppe Moscati - Aversa, Italy., Foreste G; Emergency and Acceptance Department, Anesthesia, Emergency and Burn Intensive Care Unit, 'A.O.R.N. A. Cardarelli', Naples, Italy., Tomasello A; Emergency and Acceptance Department, Anesthesia, Emergency and Burn Intensive Care Unit, 'A.O.R.N. A. Cardarelli', Naples, Italy., Villani R; Emergency and Acceptance Department, Anesthesia, Emergency and Burn Intensive Care Unit, 'A.O.R.N. A. Cardarelli', Naples, Italy.
Jazyk: angličtina
Zdroj: Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2023 Jan 25; Vol. 11 (1), pp. e4808. Date of Electronic Publication: 2023 Jan 25 (Print Publication: 2023).
DOI: 10.1097/GOX.0000000000004808
Abstrakt: The presence of a high number of positive SARS-CoV-2 patients is found daily in the emergency room database, finding evidence of infection also in trauma and burns. Surgical debridement remains the gold standard for eschar removal, but it does not come without complications such as bleeding and high heat loss. In recent years, there has been an increase in the use of enzymatic debridement techniques, replacing surgical escharotomy. Early eschar removal is proven to be important; it has been proved that an early and effective burn treatment in COVID-19 patients can reduce other infection. Five clinical cases of patients arrived at our COVID-19 Major Burns Intensive Care Unit. On admission, burns extension and depth were assessed by an expert burn surgeon. We evaluated eschar removal modality, adverse events, and potential side effects. Enzymatic debridement was efficient in all patients treated with complete eschar removal, and no serious adverse events. All patients were treated within 24 hours of arrival at our facility with Nexobrid by specialized personnel in deep sedation and with O 2 support using a face mask or nasal goggles. The use of enzymatic debridement in COVID-19-positive burn patients within dedicated pathways through nonsurgical treatment optimizes the treatment time. We believe that the use of enzymatic debridement could be a valid therapeutic option in burn patients, even with SARS-CoV-2 infection, and its use, when indicated, is safe and effective for the patient and optimizes the use of instrumental and human resources in a pandemic emergency.
Competing Interests: Disclosure: The authors have no financial interest in relation to the content of this article.
(Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze: MEDLINE
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