Abstract title:	
Enzymatic debridement of genital burns as alternative to common approaches

Objectives
Usually deep burn injuries are treated with early debridement. In contrast to this, many burn surgeons prefer a wait-and-see behavior when it comes to deep genital burns. A successful outcome is particularly important for rare genital burns, though especially here only few information and treatment guidelines can be found. In order to promote spontaneous healing, the debridement should be as modest as possible, but sufficient to facilitate spontaneous healing.
A new therapeutic approach is the tissue-sparing enzymatic debridement of genital burn wounds based on bromelain, which we compared to current therapies.

Methods
First a literature review on the treatment of genital burns was performed on PubMed between 1990 and 2016. Afterwards all patients were evaluated who were treated for genital and perineal burns between 1995 and 2016 in our clinic.

Results
As reported in most cases found in the literature, our 149 patients with genital and perineal burns were treated conservatively in a wait-and-see behavior. 
If necrosis of the skin developed in the course of the treatment, they were debrided surgically and covered with a split skin graft. 
All three patients with genital burns treated with enzymatic debridement healed spontaneously without the need of skin grafting and with good functional and aesthetic outcome.

Conclusion
Compared to surgical debridement of genital burns, enzymatic debridement helps to preserve vital tissue in this sensitive region which can reduce the need of skin grafting and can help achieve good aesthetic and functional results. Therefore enzymatic debridement is an interesting alternative for these burn injuries.

Additional information	
Ribitsch, Benedikt, MD; Schiefer, Jennifer Lynn, PhD, MD; Fuchs, Paul Christian, PhD, MD; Schulz, Alexandra, PhD, MD

2 - Enzymatic debridement of genital burns as alternative to common approaches