Effectiveness of Enzymatic Necrolysis in Patients with Burns

Rationale. Currently, there has been developed a technique for managing enzymatic necrolysis of II-III degree burn wounds using the two-component drug NexoBrid; this treatment option is possible to apply only in the early terms, up to 72 hours, after injury. There are no indications for the use of the technology in later terms after the injury. The aim of research was to study the potential and effectiveness of enzymatic necrolysis when using the drug NexoBrid in patients with burns of II-III degree at various stages after injury (before and after 72 hours). Methods. The study included 23 patients. In 15 cases, enzymatic necrolysis with Nexobrid was carried out in first 72 hours after injury; in 8 cases, in 5-9 days after injury. Results. In both groups, comparable results were obtained regarding the effectiveness of enzymatic necrolysis. The use of enzymatic necrolysis at the late stages (7 days) after injury was effective in the presence of moist necrotic tissue in the wounds, which allowed simultaneously, in the shortest possible time, cleaning burn wounds with uncomplete dermal necrosis (borderline burns of II degree and “mosaic” burns II-III degree) from necrosis, transforming wound process to second stage, creating conditions for regeneration of borderline and “mosaic” burns from the remaining skin derivatives with underlying use of dressings, thus creating a moist wound environment, and in the case of deep burns, reducing the time of their preparation and the area of autodermoplasty. Conclusion. The use of enzymatic necrolysis with the drug NexoBrid in patients with burns of II-III degree is effective up to 7 days after injury in the presence of a moist scab in the wounds.