EVALUATION OF BURNED HAND FUNCTION AFTER ENZYMATIC DEBRIDEMENT

Summary Hand burns are common injuries that can result in long-term impairment of hand function. Enzymatic debridement prevents damage to the viable dermis thanks to the procedure's selectivity and has become an option for obtaining an accurate depth assessment and enabling wound reepithelialisation with less skin graft use. We conducted a prospective study from July 2015 to July 2018, which enrolled patients with deep partial-thickness hand burns and treated them with enzymatic debridement using bromelain. After a specified period, we assessed the patients’ hand function, using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Michigan Hand Outcomes Questionnaire (MHOQ) to assess their disabilities and activities of daily life, respectively. We assessed the hand joint range of motion using a goniometer and assessed scar quality with the Vancouver Scar Scale. We analysed 72 patients with 90 burned hands at 3 months and, at the final assessment, 69 patients with 86 burned hands. Fire was the most common cause of the burns. Bromelain allowed for early debridement (73.6% during the first 24 h). At the 3-month evaluation, the mean DASH and MHOQ scores were 2.35 and 97.9%, respectively, with a high inverse correlation between the two types of scores (Spearman's rho, −0.78; p Enzymatic debridement with Bromelain in deep partial-thickness hand burns resulted in normal values at 3 months and at over 1 year of follow-up, with complete restoration of function and quality of life and good scar results.