Enzymatic Debridement in Geriatric Burn Patients-A Reliable Option for Selective Eschar Removal.

Autor: Tapking C; Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany., Rontoyanni VG; Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA., Diehm YF; Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany., Strübing F; Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany., Solimani F; Department of Dermatology, Venereology and Allergology, Charité Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, 10099 Berlin, Germany.; Berlin Institute of Health at Charité, Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, 10178 Berlin, Germany., Bigdeli AK; Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany., Hundeshagen G; Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany., Fischer S; Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany., Kneser U; Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany., Siegwart LC; Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Klinik Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Mar 31; Vol. 12 (7). Date of Electronic Publication: 2023 Mar 31.
DOI: 10.3390/jcm12072633
Abstrakt: The treatment of geriatric burn patients represents a major challenge in burn care. The objective of this study was to evaluate the efficacy of enzymatic debridement (ED) in geriatric burn patients. Adult patients who received ED for treatment of mixed pattern and full thickness burns (August 2017-October 2022) were included in this study and grouped in the younger (18-65 years) and geriatric (≥65 years) groups. Primary outcome was a necessity of surgery subsequent to ED. Both groups (patient characteristics, surgical and non-surgical treatment) were compared. Multiple logistic and linear regression models were used to identify the effect of age on the outcomes. A total of 169 patients were included (younger group: 135 patients, geriatric group: 34 patients). The burn size as indicated by %TBSA (24.2 ± 20.4% vs. 26.8 ± 17.1%, p = 0.499) was similar in both groups. The ASA (2.5 ± 1.1 vs. 3.4 ± 1.1, p < 0.001) and ABSI scores (6.1 ± 2.8 vs. 8.6 ± 2.3, p < 0.001) were significantly higher in the geriatric group. The %TBSA treated with ED (5.4 ± 5.0% vs. 4.4 ± 4.3%, p = 0.245) were similar in both groups. The necessity of additional surgical interventions (63.0 % vs. 58.8 %, p = 0.763) and the wound size debrided and grafted (2.9 ± 3.5% vs. 2.2 ± 2.1%; p = 0.301) were similar in both groups. Regression models yielded that age did not have an effect on efficacy of ED. We showed that ED is reliable and safe to use in geriatric patients. Age did not have a significant influence on the surgical outcomes of ED. In both groups, the size of the grafted area was reduced and, in many patients, surgery was avoided completely.
Databáze: MEDLINE
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