Folia Medica Indonesiana
ISSN 0303-7932
Vol. 45 / No. 3 / Published : 2009-07
Order : 6, and page :208 - 213
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Original Article :
The efficacy of combined cream bromelain - liposome as enzymatic debriding agent for deep burn patients
Author :
- Magda Hutagalung*1
- M. Sjaifuddin Noer*2
- Department of Plastic Reconstructive and Aesthetic Surgery Faculty of Medicine, Airlangga University Dr. Soetomo Hospital, Surabaya
- Department of Plastic Reconstructive and Aesthetic Surgery Faculty of Medicine, Airlangga University Dr. Soetomo Hospital, Surabaya
Abstract :
Burns remain a major source of severe injury involving all age groups, often resulting in high morbidity and mortality. Deep burns characterized by necrotic tissue called ‘eschar’ requiring early excision for patient’s survival and recovery. Despite the advantages of early excision, there are often contraindications to surgical debridement. Enzymatic debridement is an alternative which effectively and selectively degrades necrotic tissue. Unfortunately, there is limited understanding and availability of this modality in Indonesia. The agent already in market requires a relatively long period to work, is very expensive and difficult to access. With a high incidence of burns, especially in Dr. Soetomo General Hospital Surabaya, efforts were made to develop the ideal enzymatic debridement agent, bromelain, which is extracted from pineapple, combined with liposome as a carrier drug. A clinical trial was performed using ‘post-test only’ design, ‘simple randomized’ and ‘single blind’ to compare the effectiveness of silversulfadiazine cream (SSD), collagenase ointment, bromelain 35% cream and combined cream bromelain 10%-liposome 6% for debridement in 24 deep burn patients (DBD). Photographic documentation of the burns was made and surface areas were measured daily with Visitrak digital. In one third of patients, histopathology preparations were made before treatment and on the fifth day of treatment, using hematoxylin eosin stain to compare lytic zone thicknesses. Statistic tests used were T-test, Anova, Post Hoc and Multivariate tests. Bromelain-liposome cream was found to be significantly more effective for enzymatic debridement of DBP compared with other the agents making it a comparable alternative for surgical debridement of DBP.
Keyword :
Burns, eschar, enzymatic debridement, bromelain-liposome cream,
References :
Jeffrey JJ. ,(1992) Collagen Degradation. In: Cohen IK, Diegelmann RF., Lindbla WJ., editors. Wound Healing, Biochemical & Clinical Aspects - : WB Saunders Company
Moenadjat Y.,(2003) Luka bakar pengetahuan klinis praktis edisi II (dengan perbaikan) Jakarta : Balai Penerbit FKUI
Archive Article
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 Volume : 45 / No. : 3 / Pub. : 2009-07 |
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