[REVIEW OF 30 YEARS OF RESEARCH AND DEVELOPMENT OF AN ENZYMATIC DEBRIDEMENT AGENT FOR BURNS].

Introduction: Early removal of burn eschar is a cornerstone of burn care. The most commonly practiced eschar removal technique for deep burns in modern burn care is surgical debridement but this technique is associated with surgical burden and leads to unnecessary excision of viable tissue.

Goals: To review 30 years of research and development of an enzymatic debridement agent for burns.

Admission cell free DNA as a prognostic factor in burns: quantification by use of a direct rapid fluorometric technique.

Background: Despite great advances in the treatment of burn patients, useful prognostic markers are sparse. During the past years there has been increasing interest in circulating plasma cell free DNA as a potential marker for tissue injury. We have developed a rapid direct fluorescent assay for cell free DNA quantification that allows obtaining accurate, fast, and inexpensive measurements.

Total lip reconstruction with tendinofasciocutaneous radial forearm flap.

Introduction: Squamous cell carcinoma is a common tumour of lower lip. Small defects created by surgical resection may be readily reconstructed by linear closure or with local flaps. However, large tumours resection often results with microstomia and oral incompetence, drooling, and speech incomprehension.

Polydactyly in the multiethnic 'Negev' population at southern Israel.

The objective of this study was to characterize the prevalence, ethnic mix, and associated malformations of polydactyly in a multiethnic population. A retrospective analysis of 189 polydactyly patients was carried out. The incidence of polydactyly was 0.

Idiopathic distal radioulnar synostosis.

Radioulnar synostosis is rare, and exists in two forms: congenital and post-traumatic. The congenital form presents only in the proximal forearm, and the post-traumatic form may present anywhere along the radius and ulna. The only known aetiology for distal radioulnar synostosis is post-traumatic.

Efficacy of enzymatic debridement of deeply burned hands.

Background: The burned hand is a common and difficult to care-for entity in the field of burns. Due to the anatomy of the hand (important and delicate structures crowded in a small limited space without sub-dermal soft tissue), surgical debridement of the burned tissue is technically difficult and may cause considerable complications and, therefore, should be performed judiciously. Selective enzymatic debridement of the burn wound can preserve the spontaneous epithelialisation potential and reduce the added injury to the traumatised tissue added by a surgical debridement.

[The burn array in Israel].

Circa 2700 burn victims require hospitalization in Israel each year. Most of these burns happen as household accidents, caused by hot liquids and involve less than 20% of the total body surface area. Treatment is dictated by the burn severity.

Long-term follow-up of high-pressure injection injuries to the hand.

Background: High-pressure injection injury is an injury caused by accidental injection of substances by industrial equipment. This injury may have devastating sequelae. The goal of this study was to assess the long-term outcome of high-pressure injection injury to the hand.

Escharotomy using an enzymatic debridement agent for treating experimental burn-induced compartment syndrome in an animal model.

Background: In patients with deep circumferential burns, adequate resolution of burn-induced compartment syndrome (BICS) is achieved by surgical escharotomy. Surgical escharotomy is traumatic, may cause considerable blood loss, does nothing toward debridement of the burn wound, and entails possible morbidity and complications. Debridase is a Bromelain derived enzymatic preparation capable of lysing the burn eschar within 4 hours, obviating the need for surgical debridement.

Three-square-flip-flap reconstruction for post burn syndactyly.

Introduction: Burns of the hands may result in the formation of web space contractures-post burn syndactyly. We present our experience using the three-square technique originally described by Bandoh for minor syndactyly.

Method: Tissues of the contracted web are regard as forming three facets of a cube.

Safety and efficacy of a proteolytic enzyme for enzymatic burn debridement: a preliminary report.

A prospective, non-comparative study design was used to describe our experience with a bromelain-derived debriding agent, Debridase, in 130 patients with 332 deep second degree and third degree burns treated between 1984 and 1999. Debridase was applied after saturating the burns with a moist dressing for 2-24h. Debridase was applied for a period of 4h under an occlusive dressing.

Transdermal scopolamine use for post-rhytidectomy sialocele.

Background: Post-rhytidectomy sialocele is a rare complication. The usual treatment uses prolonged drainage. The use of antisialogogues has been described previously, but has potential side effects.