Since its approval in Europe, our Plastic and Reconstructive Department has started implementing enzymatic debridement in the protocol of care of burn patients with mixed pattern burns as an alternative of the classic surgical eschar removal. This article aims to present the impact of enzymatic debridement on the hemodynamic evolution of a series of burn patients who suffered thermal injuries by flames mechanism.
Results
25 out of 27 patients had an average of 12% TBSA application area. The 2 particular patients had an off label application area of 18%. We found no significant differences concerning body temperature and blood pressure during and the couple of days following the enzymatic debridement procedure. Also, no side effects of the debridement product were observed during and after the treatment. Except hemoglobin drop due to bleeding which was manageable in the ICU if needed and did not put patient at risk, improvement of the hemodynamics could be seen compared to the blood tests before the debridement procedure. We observed a leukocyte count drop, lactate, CRP and CK and CK-MB value drop the days following the treatment, but no significant differences of the fibrinogen values. Also, there were no major changes of the electrolytes levels before and after product application.
Materials and Methods
Between January 2019 and March 2021 a number of 27 patients with mixed pattern burns underwent enzymatic debridement. The trunk and the lower extremities were the main areas where the enzymatic agent was applied. Patients were treated following the European Consensus Protocol, in the early stage of the burn (between 12 and 72 hours since the injury moment), but 2 particular patients underwent enzymatic debridement on more than 15% TBSA. The bromelain based treatment was evaluated for the systemic inflammatory reaction and hemodynamic evolution.
Conclusions
11.15
Average values at Admission vs Post Nexobrid aplication
17.4875
12.425
548
489
86
47
Admission Post Nexobrid
Bromelain based enzymatic debridement is a safe alternative to eschar burn removal in mixed pattern burs, especially when following the Consensus Guidelines, which can bring an improvement non only on the local evolution of the condition, but also in the hemodynamic stability of the burn patient. Selective eschar removal preserves local healing resources, does not compromise the general state of the patient and copes with downsizing the inflammatory systemic response.

Since its approval in Europe, our Plastic and Reconstructive Department has started implementing enzymatic debridement in the protocol of care of burn patients with mixed pattern burns as an alternative of the classic surgical eschar removal. This article aims to present the impact of enzymatic debridement on the hemodynamic evolution of a series of burn patients who suffered thermal injuries by flames mechanism.
**Results**
25 out of 27 patients had an average of 12% TBSA application area. The 2 particular patients had an off label application area of 18%. We found no significant differences concerning body temperature and blood pressure during and the couple of days following the enzymatic debridement procedure. Also, no side effects of the debridement product were observed during and after the treatment. Except hemoglobin drop due to bleeding which was manageable in the ICU if needed and did not put patient at risk, improvement of the hemodynamics could be seen compared to the blood tests before the debridement procedure. We observed a leukocyte count drop, lactate, CRP and CK and CK-MB value drop the days following the treatment, but no significant differences of the fibrinogen values. Also, there were no major changes of the electrolytes levels before and after product application.
**Materials and Methods**
Between January 2019 and March 2021 a number of 27 patients with mixed pattern burns underwent enzymatic debridement. The trunk and the lower extremities were the main areas where the enzymatic agent was applied. Patients were treated following the European Consensus Protocol, in the early stage of the burn (between 12 and 72 hours since the injury moment), but 2 particular patients underwent enzymatic debridement on more than 15% TBSA. The bromelain based treatment was evaluated for the systemic inflammatory reaction and hemodynamic evolution.
**Conclusions**
**11.15**
**Average values at Admission vs Post Nexobrid aplication**
**17.4875**
**12.425**
**548**
**489**
**86**
**47**
Admission Post Nexobrid
Bromelain based enzymatic debridement is a safe alternative to eschar burn removal in mixed pattern burs, especially when following the Consensus Guidelines, which can bring an improvement non only on the local evolution of the condition, but also in the hemodynamic stability of the burn patient. Selective eschar removal preserves local healing resources, does not compromise the general state of the patient and copes with downsizing the inflammatory systemic response.

P.036 INFLUENCE OF BROMELAIN BASED ENZYMATIC DEBRIDEMENT IN HEMODYNAMIC EVOLUTION OF THE BURN PATIENT – CASE SERIES

Dear friends and colleagues,

We will be pleased to welcome you in Turin (Italy) for the 19th European Burns Association´s Congress in 2022. Italy is honored to hold the meeting of the European Burns Association for the second time, after Verona in 1995. Turin is easily reachable from everywhere in Europe, either travelling by car, train or choosing flight connections. During the meeting, held in the renewed industrial center of the main Italian historical automotive factory (i.e. Lingotto-FIAT), we will meet international burn specialists, focusing on standards of care, progresses in burn treatment, strategies to face disaster situations, with a special attention to education of younger colleagues. However, in your spare time, you might enjoy the sweet days of Italian late summer, simply wandering in the green parks and gardens along the two rivers which cross the city, or you might decide to discover the numerous art galleries, churches, palaces, libraries, walking across elegant squares and large boulevards, passing through centuries of art and history; finally, you may choose to immerse yourself in some of the most exciting museum experiences, such as the Cinema Museum and the Turin’s Egyptian museum.

Looking forward to seeing you all in Turin for the 19th European Association´s Congress in 2022!
Maurizio Stella, Congress President, Turin Burn Centre