Facial burns represent a big challenge even for more talented and expert surgeons.

Traditional surgery, dermabrasion or water jet method can be useful, but definitely more aggressive and less selective than enzymatic debridement, with additional necessity of operating theatre to perform the procedure.

Enzymatic debridement as a novel approach allows the removal of burn eschar on early basis admission in 4 hour application, respecting the remanences vital structures, especially dermis, fundamental for scarless epithelisation.





Methods
From February 2017 in our Burn Unit we started performing enzymatic debridement on our burn patients. We treated 6 patients ( out of 26 patients) with facial burn injury. Most of them had other burn injuries including inhalators one.



Results
All the patients were treated within 36 hours after admission meanly ( 0-72 hours). Patients were four man and two females, mean age 36,25 ( 1,5 - 53 age) years old. They were mainly affected with 19,3% TBSA% ( 3-37%) burn injuries and some of them as well with inhalation injuries. None of them needed operating theatre for enzymatic debridement procedure. Allo transplants were applied afterwords. No blood transfusion was necessary. One out of six patients needed skin grafting due to a sepsis and one out of 6 patients had a serious damage of nose structure. The spontaneous wound healing was present within 14-20 day after injury.



Conclusion
These preliminary experiences encourage to perform enzymatic debridement on early basis admission like surgical procedure, permitting preservation of vital structures, reducing functional and cosmetic sequelae.

1 - FACIAL BURNS AND ENZYMATIC DEBRIDEMENT PRELIMINARY CASES