Review
Dermatology
Kazuki Shimada, Yosuke Ojima, Yukiko Ida, Hajime Matsumura
Summary: Hydrosurgery has shown advantages in rapid and high-quality debridement for chronic wounds, saving time compared to conventional methods, and requiring fewer repetitions to achieve adequate wound beds, leading to potential success and cost-effectiveness in subsequent treatments.
INTERNATIONAL WOUND JOURNAL
(2021)
Article
Biochemistry & Molecular Biology
Wolfram Heitzmann, Mitja Mossing, Paul Christian Fuchs, Jan Akkan, Harun Seyhan, Gerrit Grieb, Christian Oplander, Jennifer Lynn Schiefer
Summary: Both Suprathel (R) and Jelonet (R) dressings are effective in promoting safe and rapid wound healing after enzymatic debridement of deep dermal burns of the hands and feet. However, Suprathel (R) shows superior results in terms of patient comfort and pain reduction compared to Jelonet (R).
Review
Dermatology
Yaron Shoham, Konstantinos Gasteratos, Adam J. Singer, Yuval Krieger, Eldad Silberstein, Jeremy Goverman
Summary: In 2012, a pineapple stem-derived Bromelain-based debridement concentrate (NexoBrid & REG;, MediWound Ltd, Yavne, Israel) was approved by the European Medicines Agency for adult deep burns. A systematic review of the literature on Nexobrid & REG; outcomes was conducted, identifying 103 relevant studies, of which 34 were eligible. The studies reported positive effects of Nexobrid & REG; on burn debridement, functional and cosmetic outcomes, scarring, and quality of life, indicating its safety and benefits as a non-surgical eschar removal treatment.
INTERNATIONAL WOUND JOURNAL
(2023)
Article
Critical Care Medicine
C. Bowers, A. Randawa, B. Sloan, U. Anwar, A. Phipps, P. Muthayya
Summary: Research on the use of bromelain-based enzymatic debridement in larger burn injuries has shown significant advantages such as reduced blood loss, improved dermal preservation, decreased need for autografting, and fewer surgical procedures. It is recommended that both the medical team and patients be prepared for enzymatic debridement in large burn injuries and establish robust local pathways prior to use.
Article
Surgery
Lisa M. Davenport, Leila Cuttle, Craig A. McBride, Roy Kimble
Summary: Escharotomies in children result in significant morbidity, with 71% of survivors requiring operative revisions of their scars. Further investigation into decompression methods and long-term morbidity is needed.
ANZ JOURNAL OF SURGERY
(2021)
Review
Critical Care Medicine
Naira Figueiredo Deana, Carlos Zaror, Mariano del Sol, Vanderlei Salvador Bagnato, Nilton Alves
Summary: This systematic review aimed to determine the effectiveness of laser photobiomodulation (laser PBM) in accelerating the wound contraction rate in excised and unexcised burn wounds. The results showed that laser PBM was effective in increasing the wound contraction rate in excised burns. However, the effect of laser on wound contraction in unexcised burns remains uncertain.
Article
Medicine, General & Internal
Christian Tapking, Victoria G. Rontoyanni, Yannick F. Diehm, Felix Struebing, Farzan Solimani, Amir K. Bigdeli, Gabriel Hundeshagen, Sebastian Fischer, Ulrich Kneser, Laura C. Siegwart
Summary: The efficacy of enzymatic debridement (ED) in geriatric burn patients was evaluated in this study. A total of 169 patients in the younger and geriatric groups were included, and it was found that ED had similar efficacy in both groups, but the geriatric group had a higher surgical risk. Therefore, ED is a reliable and safe treatment option for geriatric burn patients.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Critical Care Medicine
Annika S. Walter, Elias Volkmer, Gerd Gauglitz, Wolfgang Boecker, Maximilian M. Saller
Summary: This systematic review summarizes the current knowledge on molecular pathways activated during burn wound healing and identifies key molecules and new research targets.
Review
Critical Care Medicine
Keng Siang Lee, Amber Young, Hayley King, A. Toby A. Jenkins, Anna Davies
Summary: This study investigated the variation in burn wound infection (BWI) definitions in systematic reviews (SRs) of burn care interventions and its impact on the identification of effective treatments. The findings revealed heterogeneity in BWI definitions, which affected the drawing of conclusions and limited the validation of effective treatments.
Article
Critical Care Medicine
Rosario Ranno, Michelangelo Vestita, Giulio Maggio, Pasquale Verrienti, Davide Melandri, Catuscia Orlandi, Giuseppe Perniciaro, Armando De Angelis, Roberto D'Alessio, Ilaria Mataro, Eliana Pagnozzi, Giovanni Alessandro, Edoardo Caleffi, Antonio Di Lonardo, Serena Ciappi, Paolo Palombo, Maria Alma Posadinu, Maurizio Stella, Mariarosa Romeo, Jasminka Minic, Maurizio Governa, Giuseppe Giudice
Summary: Italian experts have provided recommendations on the use of Nexobrid (R), an enzymatic debridement, in burn surgery. Through a multi-phase process based on the Delphi method, experts reached consensus on the majority of statements, providing a valuable set of recommendations for clinicians. These recommendations are specific to the Italian experience and will be updated as new evidence becomes available.
Article
Medicine, Research & Experimental
Tomasz Korzeniowski, Jerzy Struzyna, Kamil Torres
Summary: This study evaluated the efficacy of bromelain-based enzymatic debridement combined with laser Doppler imaging (LDI) in the treatment of burns. The results showed that LDI can reliably assess perfusion of burn wounds and help predict healing time.
MEDICAL SCIENCE MONITOR
(2022)
Review
Surgery
Yiji Tu, William C. Lineaweaver, Andrew Breland, Feng Zhang
Summary: This study aimed to review recent fungal infection case reports and evaluate treatment regimens and clinical outcomes, finding that fungal wound infection still has a high mortality rate in burn patients worldwide, especially those infected with non-Candida species. Early diagnosis, initiation of appropriate antifungal therapy, and effective surgical intervention are key measures to improve treatment outcomes and reduce mortality in burn patients with fungal infection.
ANNALS OF PLASTIC SURGERY
(2021)
Review
Medicine, General & Internal
Sebastian Flores-Escobar, Francisco Javier Alvaro-Afonso, Yolanda Garcia-Alvarez, Mateo Lopez-Moral, Jose Luis Lazaro-Martinez, Esther Garcia-Morales
Summary: Ultrasound-assisted wound debridement showed higher healing rates and a greater percentage of wound area reduction compared to placebo and standard care in patients with diabetic foot ulcers, with similar healing times observed between groups.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Dermatology
David M. Fairlamb, Bela Kelety, Anke Bachert, Anika Scholtissek, Richard D. Jones, Stephen C. Davis, Robert S. Kirsner
Summary: A recombinant proteolytic enzyme derived from maggot saliva has been studied for its potential use as a debridement agent for chronic wounds. The enzyme has been found to have a good safety profile and is rapidly inactivated in the systemic circulation. In-vitro and in-vivo studies have shown that the enzyme has fibrinolytic action and additional proteolytic action against collagen and elastin, making it a promising candidate for clinical use.
INTERNATIONAL WOUND JOURNAL
(2023)
Review
Critical Care Medicine
Giuseppe A. G. Lombardo, Francesco Ciancio, Hillary Violini, Claudia Sapuppo, Santo Zagami, Adelina Vena, Maria Giardina, Claudio Donia, Rosario Ranno
Summary: This retrospective study examines the use of Nexobrid, an enzymatic debriding agent, in burn debridement at a major Italian burn center. The study finds that while Nexobrid shows potential in reducing the need for surgical intervention and faster eschar removal, its effectiveness varies across patients. The majority still require additional surgical procedures. The authors suggest future research should include randomized controlled trials, direct comparisons with traditional debridement methods, and larger and more diverse patient groups.
JOURNAL OF BURN CARE & RESEARCH
(2023)
Article
Surgery
Sebastian Fischer, Yannick Diehm, Miguel I. Dorante, Dimitra Kotsougiani, Maximilian Kueckelhaus, Muayyad Alhefzi, Ericka M. Bueno, Bohdan Pomahac
Letter
Surgery
Sebastian Fischer, Dimitra Kotsougiani, Ulrich Kneser, Christoph Hirche
Article
Orthopedics
Valentin F. M. Haug, Yannick F. Diehm, Peter Pfeiler, Dimitra Kotsougiani-Fischer, Berthold Bickert, Ulrich Kneser, Christoph Hirche, Sebastian Fischer
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
(2020)
Article
Surgery
Yannick F. Diehm, Yanic Jost, Dimitra Kotsougiani-Fischer, Valentin Haug, Mona Splinter, Peter Haering, Martin R. Berger, Juergen Debus, Ulrich Kneser, Sebastian Fischer
Summary: The injection of Clostridium histolyticum collagenase (CCH) has been shown to be a safe and effective approach in degrading capsule tissue induced by fractionated irradiation in an animal model. It significantly reduces capsule thickness and collagen density, potentially paving the way for clinical application in implant-based breast reconstruction patients.
AESTHETIC PLASTIC SURGERY
(2021)
Article
Surgery
Yannick F. Diehm, Sebastian Fischer, Emre Gazyakan, Gabriel Hundeshagen, Dimitra Kotsougiani-Fischer, Florian Falkner, Ulrich Kneser, Christoph Hirche
Summary: The study found that adding NPWT to ADSS treatment significantly improved rates of ADSS integration and skin graft take, reduced infection rates, and allowed for earlier surgery, making it a beneficial adjunct.
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
(2021)
Article
Surgery
Laura C. Siegwart, Laura Sieber, Sebastian Fischer, Spyridoula Maraka, Ulrich Kneser, Dimitra Kotsougiani-Fischer
Summary: Closed incision negative-pressure therapy can reduce the incidence of surgical site complications in abdominal-based free-flap breast reconstruction.
Article
Surgery
D. Kotsougiani-Fischer, J. S. Choi, J. S. Oh-Fischer, Y. F. Diehm, V. F. Haug, L. Harhaus, E. Gazyakan, C. Hirche, U. Kneser, S. Fischer
Article
Surgery
Per Heden, Sebastian Fischer
Summary: A study compared the outcomes of segmental fat grafting technique and traditional fat transposition technique in lower blepharoplasty, and found that segmental fat grafting could significantly reduce tear trough width and was recognized by plastic surgery experts. There were no significant differences in complications and revision surgery rates between the two study groups.
AESTHETIC SURGERY JOURNAL
(2021)
Letter
Surgery
Yannick F. Diehm, Yanic Jost, Dimitra Kotsougiani-Fischer, Sebastian Fischer
AESTHETIC PLASTIC SURGERY
(2021)
Article
Surgery
Valentin Haug, Nikita Kadakia, Alice T. Wang, Miguel I. Dorante, Adriana C. Panayi, Martin Kauke-Navarro, Gabriel Hundeshagen, Yannick F. Diehm, Sebastian Fischer, Christoph Hirche, Ulrich Kneser, Bohdan Pomahac
Summary: This study evaluates differences in surgical outcomes after breast reduction surgery based on patients' ethnicities. After propensity score matching, there were no significant differences in major complications between White and non-White patients, but non-White patients had fewer minor surgical complications. The number of non-White patients seeking breast reduction surgery has also increased.
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
(2022)
Article
Oncology
Yannick Fabian Diehm, Katharina Marstaller, Anna-Maria Seckler, Martin Reinhold Berger, Michael Zepp, Matthias Martin Gaida, Julia Thome, Dimitra Kotsougiani-Fischer, Ulrich Kneser, Sebastian Fischer
Summary: This study investigated the impact of CCH treatment on breast cancer cells. The results showed that CCH had an effect on the proliferation and wound healing of breast cancer cells in vitro and in vivo, but did not significantly change the cell cycle and apoptosis. No evidence of metastasis was observed in the in vivo experiments, and no relevant alterations in metastasis-related genes were detected. Therefore, CCH does not have an impact on tumor growth or metastasis formation.
Article
Multidisciplinary Sciences
Yannick F. Diehm, Dimitra Kotsougiani-Fischer, Elena Porst, Valentin Haug, Laura C. Siegwart, Daniel Overhoff, Ulrich Kneser, Sebastian Fischer
Summary: The study found that Doxycycline can inhibit the activity of CCH and reduce skin lacerations after treatment. Although oral Doxycycline does not interfere with capsule formation or the effectiveness of CCH in dissolving fibrotic capsule tissue, it can increase skin thickness and collagen density.
Review
Surgery
Alice T. Wang, Adriana C. Panayi, Sebastian Fischer, Yannick F. Diehm, Christian Tapking, Gabriel Hundeshagen, Ulrich Kneser, Melissa Mastroianni, Bohdan Pomahac, Valentin Haug
Summary: Reduction mammoplasty significantly improves the patient-reported quality of life, especially in terms of breast satisfaction. Preoperative scores are lower than the normative data, but improve to comparable levels with the healthy population postoperatively. The improvement is not correlated with patient comorbidities, complication rates, or the amount of breast tissue resected.
AESTHETIC SURGERY JOURNAL
(2023)
Article
Medicine, General & Internal
Miguel Dorante, Branislav Kollar, Doha Obed, Valentin Haug, Sebastian Fischer, Bohdan Pomahac