Objectives Burn management is resource intensive. NexobridTM (NXB) is efficacious for enzymatic debridement, indicated for deep partial- and full-thickness thermal burns, and may reduce resource usage. We assessed its effects on resource utilization in anticipation of mass casualty management.
Methods Data on patient characteristics, and the utilization of human resources, operating room time, and blood transfusions were retrospectively collected for adult patients treated at the Verona burn center. Patients who underwent enzymatic debridement with NXB (n=20) were compared with patients matched for age, burn area and depth (n=20) who had received surgical debridement as standard of care (SOC). Results were analyzed using descriptive statistics and log Gamma modeling. Institutional Review Board approval #2214CESC.
Results Mean (±SD) ages were similar between groups: SOC, 54±15 years, 13/20 men; NXB, 56±15 years, 15/20 men. One or more major comorbidity was present in 10 patients in each group, mean (±SD) 2.1±1.1 comorbidity per affected patient in SOC, and mean 1.8±0.92 per affected patient in NXB. Initial burn parameters were also similar (Table). During debridement, use of NXB was associated with fewer mean operating room procedures (0.15±0.366 vs. 1.5±0.607; p<0.01), fewer surgeon hours (77±22 vs. 159±76; p<0.01), and lower hospital resource utilization (Figure 1A). The log Gamma model confirms that during debridement NBX was significantly associated with fewer days of hospitalization, fewer operating room procedures, and significantly lower hospital staff involvement, total healthcare utilization, and blood units consumed (all p<0.001). At discharge, NXB was associated with fewer OR procedures (1.05±0.605 vs. 1.8±0.616; p<0.01) and the involvement of fewer surgeons (2.2±0.894 vs. 3.85±1.268; p<0.01), anesthesiologists (1.2±0.41 vs. 1.8±0.616; p<0.01), and nurses (3.6±1.57 vs. 5.7±1.455; p<0.01) (Figure 1B). The log Gamma model confirmed NBX was significantly associated with fewer operating room procedures (p=0.011), a lower number of hospital staff involved (p=0.003), and less total staff time utilization (p<0.001); total hospital days at discharge were similar (NXB 38±12 vs. SOC 43±17).
Conclusion Enzymatic debridement is an effective means to reduce hospital resource utilization for burn eschar removal. By allowing non-surgeons to perform debridement outside of the operating theater, it may overcome surgical bottlenecks associated with the management of multiple burn patients, e.g., in the event of a mass casualty incident involving burn patients. Implementation of enzymatic debridement may increase burn center surge capacity and should be considered in preparedness assessments.

**Objectives** Burn management is resource intensive. NexobridTM (NXB) is efficacious for enzymatic debridement, indicated for deep partial- and full-thickness thermal burns, and may reduce resource usage. We assessed its effects on resource utilization in anticipation of mass casualty management.
**Methods** Data on patient characteristics, and the utilization of human resources, operating room time, and blood transfusions were retrospectively collected for adult patients treated at the Verona burn center. Patients who underwent enzymatic debridement with NXB (n=20) were compared with patients matched for age, burn area and depth (n=20) who had received surgical debridement as standard of care (SOC). Results were analyzed using descriptive statistics and log Gamma modeling. Institutional Review Board approval #2214CESC.
**Results** Mean (±SD) ages were similar between groups: SOC, 54±15 years, 13/20 men; NXB, 56±15 years, 15/20 men. One or more major comorbidity was present in 10 patients in each group, mean (±SD) 2.1±1.1 comorbidity per affected patient in SOC, and mean 1.8±0.92 per affected patient in NXB. Initial burn parameters were also similar (**Table**). During debridement, use of NXB was associated with fewer mean operating room procedures (0.15±0.366 vs. 1.5±0.607; p<0.01), fewer surgeon hours (77±22 vs. 159±76; p<0.01), and lower hospital resource utilization (**Figure 1A**). The log Gamma model confirms that during debridement NBX was significantly associated with fewer days of hospitalization, fewer operating room procedures, and significantly lower hospital staff involvement, total healthcare utilization, and blood units consumed (all p<0.001). At discharge, NXB was associated with fewer OR procedures (1.05±0.605 vs. 1.8±0.616; p<0.01) and the involvement of fewer surgeons (2.2±0.894 vs. 3.85±1.268; p<0.01), anesthesiologists (1.2±0.41 vs. 1.8±0.616; p<0.01), and nurses (3.6±1.57 vs. 5.7±1.455; p<0.01) (**Figure 1B**). The log Gamma model confirmed NBX was significantly associated with fewer operating room procedures (p=0.011), a lower number of hospital staff involved (p=0.003), and less total staff time utilization (p<0.001); total hospital days at discharge were similar (NXB 38±12 vs. SOC 43±17).
**Conclusion** Enzymatic debridement is an effective means to reduce hospital resource utilization for burn eschar removal. By allowing non-surgeons to perform debridement outside of the operating theater, it may overcome surgical bottlenecks associated with the management of multiple burn patients, e.g., in the event of a mass casualty incident involving burn patients. Implementation of enzymatic debridement may increase burn center surge capacity and should be considered in preparedness assessments.

P.053 Potential benefits of NexobridTM vs standard of care for burn center mass casualty management

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