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Bromelain-based enzymatic debridement of e-cigarette burns: a single unit experience.
J Wound Care 2019; 28(11):758-761JW

Abstract

OBJECTIVE

It is widely accepted that the early debridement of burns improves outcome. There is increasing evidence that enzymatic debridement is an effective technique for removal of full-thickness and deep-dermal burns, reducing blood loss and often the need for autologous skin grafting by avoiding over excision of the burn. We aim to highlight the potential use of this form of debridement as an alternative to surgical management in patients with electronic cigarette (e-cigarette)-associated flame burn injuries.

METHODS

This case series presents the use of Nexobrid (MediWound Ltd, Israel), a non-surgical, bromelain-based enzymatic debridement technique, in patients with deep partial-thickness burns (range: 1-3% total body surface area), avoiding the need for autologous skin grafting.

RESULTS

Burn wounds in two patients healed within 14 days without complications or the need for further surgical intervention. Another patient required further dressings after discharge but failed to attend follow-up appointments. These results are comparable with those reported by others using conservative management of e-cigarette burns.

CONCLUSION

The authors wish to raise awareness of the potential for a combination of thermal and chemical burns related to e-cigarette explosions. Chemical burns should be excluded by pH testing of the burn wound. From our experience, small e-cigarette-associated flame burns can be considered for management with enzymatic debridement.

Authors+Show Affiliations

Department of Plastic Surgery, Ulster Hospital, Dundonald, BT16 1RH, Northern Ireland, UK.Department of Plastic Surgery, St John Hospital, Livingstone, Livingston EH54 6PP, Scotland, UK.Department of Plastic Surgery, St John Hospital, Livingstone, Livingston EH54 6PP, Scotland, UK.Department of Plastic Surgery, St John Hospital, Livingstone, Livingston EH54 6PP, Scotland, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31721672

Citation

Ho, Weiguang, et al. "Bromelain-based Enzymatic Debridement of E-cigarette Burns: a Single Unit Experience." Journal of Wound Care, vol. 28, no. 11, 2019, pp. 758-761.
Ho W, Jones CD, Widdowson D, et al. Bromelain-based enzymatic debridement of e-cigarette burns: a single unit experience. J Wound Care. 2019;28(11):758-761.
Ho, W., Jones, C. D., Widdowson, D., & Bahia, H. (2019). Bromelain-based enzymatic debridement of e-cigarette burns: a single unit experience. Journal of Wound Care, 28(11), pp. 758-761. doi:10.12968/jowc.2019.28.11.758.
Ho W, et al. Bromelain-based Enzymatic Debridement of E-cigarette Burns: a Single Unit Experience. J Wound Care. 2019 Nov 2;28(11):758-761. PubMed PMID: 31721672.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bromelain-based enzymatic debridement of e-cigarette burns: a single unit experience. AU - Ho,Weiguang, AU - Jones,Christopher D, AU - Widdowson,Daniel, AU - Bahia,Hilal, PY - 2019/11/14/entrez PY - 2019/11/14/pubmed PY - 2019/11/14/medline KW - bromelain KW - burns KW - electronic cigarette KW - enzymatic debridement SP - 758 EP - 761 JF - Journal of wound care JO - J Wound Care VL - 28 IS - 11 N2 - OBJECTIVE: It is widely accepted that the early debridement of burns improves outcome. There is increasing evidence that enzymatic debridement is an effective technique for removal of full-thickness and deep-dermal burns, reducing blood loss and often the need for autologous skin grafting by avoiding over excision of the burn. We aim to highlight the potential use of this form of debridement as an alternative to surgical management in patients with electronic cigarette (e-cigarette)-associated flame burn injuries. METHODS: This case series presents the use of Nexobrid (MediWound Ltd, Israel), a non-surgical, bromelain-based enzymatic debridement technique, in patients with deep partial-thickness burns (range: 1-3% total body surface area), avoiding the need for autologous skin grafting. RESULTS: Burn wounds in two patients healed within 14 days without complications or the need for further surgical intervention. Another patient required further dressings after discharge but failed to attend follow-up appointments. These results are comparable with those reported by others using conservative management of e-cigarette burns. CONCLUSION: The authors wish to raise awareness of the potential for a combination of thermal and chemical burns related to e-cigarette explosions. Chemical burns should be excluded by pH testing of the burn wound. From our experience, small e-cigarette-associated flame burns can be considered for management with enzymatic debridement. SN - 0969-0700 UR - https://www.unboundmedicine.com/medline/citation/31721672/Bromelain_based_enzymatic_debridement_of_e_cigarette_burns:_a_single_unit_experience_ L2 - http://www.magonlinelibrary.com/doi/full/10.12968/jowc.2019.28.11.758?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -