PMC7231992_01
A: Pre-debridement. Deep facial burns clinically diagnosed as mixed deep dermal/third degree. B: Pre-debridement. Third degree burns at both of the hands according to clinical criteria.
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The burn depth was diagnosed clinically as mixed deep dermal/third degree of 12% TBSAB (third-degree burns at hands, neck and lower part of the face, total 6%) and superficial burns of 4% TBSAB (Fig. 1). Because of inhalation injury, the patient was intubated immediately at admission. There was an extensive edema of the epiglottis and a huge mass of carbon blacks in examined airways.
A: Post-debridement. A vital dermis was found at the wound bed of the whole facial area after debridement. B: Post-debridement. The thrombotized vessels remained in the wound beds after debridement on both hands.
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Single debridement efficacy was 95% on the face, neck and trunk and 90% on both hands. (Fig. 2) In the high-risk patient with unstable circulation enzymatic debridement proved to be safe and effective.
A: Follow-up. Inconspicuous scar formation after spontaneous healing in the facial area with few sebaceous cysts at chin. B: Follow-up. Appropriate scar formation of the grafted areas on both hands with scar contracture on the right hand.
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We followed-up the patient for 20 months after the injury (Fig. 3).