Two Cases of Enzymatic Debridement for Deep Burn Wounds Associated with Automobile Run-over Injuries

Run-over injuries, particularly those involving burns from vehicle exhaust systems, present significant challenges due to the complexity of associated trauma. This report details two cases where enzymatic debridement using anacaulase was employed for burns sustained during run-over incidents. Both cases involved extensive injuries, including fractures and pulmonary complications, necessitating careful timing of debridement. Anacaulase facilitated early, selective removal of necrotic tissue, preserving healthy dermal layers and reducing the area for autografting. Despite initial challenges, including insufficient debridement in areas with low petechial bleeding, outcomes were favorable with minimal blood loss. The first case required a skin graft on Day 35, while the second was on Day 48, highlighting variability based on injury severity and thermal exposure. These cases suggest anacaulase as a valuable alternative to surgical debridement, especially in complex trauma cases where conventional methods are less feasible. Further research is warranted to optimize its use in burn treatment protocols.