Resumo

Objectives: The clinical efficacy of stromal vascular fraction (SVF) and platelet-rich fibrin (PRF) for the treatment of thermal wounds after enzymatic debridement is evaluated. Introduction: Enzymatic debridement for severe burn injuries is an attractive alternative to conventional invasive excision by knife. Bromelain-based enzymes extracted from pineapples permit a selective removal of burn eschar that preserves the dermis and thus grants improved long-term outcomes. Once the burn eschar is removed, it presents a promising scaffold for autologous cells and growth factors to stimulate the body-own regeneration with the ultimate goal to circumvent skin grafting. Materials / method: In this study, patients with deep partial thickness burns (DPTBs) that were treated at the Burn Center of the Zurich University Hospital underwent enzymatic debridement of selected areas followed by autologous SVF-PRF treatment. Outcome including time to epithelization, complications, and the need for skin grafting were evaluated. Results: A total of 13 patients (7 male, 6 female) underwent the afore-mentioned treatment. The average injured total burn surface area (TBSA) was 6.83%. The time to heal varied heavily and ranged from 10-42 days. Five patients needed subsequent skin grafting due to insufficient healing. Beyond incomplete wound healing, no other therapy-related complications were observed. Conclusion: In theory, the combination of enzymatic debridement and SVF-PRF application is an appealing, regenerative approach that in practice, however, requires further optimization as it cannot level autologous skin grafting as the gold standard.