Dr Jennifer Schiefer1, Prof. Paul Fuchs1, Dr. Christian Opländer2
1Clinic For Plastic And Reconstructive Surgery, Burn Center Hospital Cologne Merheim, University of Witten/Herdecke, Cologne, Germany, 2University of Witten/Herdecke, Witten, Germany
Background: In many countries, chemical industry uses Diphortine® for chemical decontamination of the eyes. It has also been reported, that Diphortine® is effective for chemical decontamination of the skin. In recent years enzymatic debridement has become popular in burn wound treatment. Nevertheless up to date enzymatic debridement is not always effective after chemical burns.
Methods: A collagen-based dermal substitute (MatriDerm®) was exposed to NexoBrid® in the presence of different acids of varying concentrations. Digestion was documented and classified independently by 3 investigators at least 3 times in succession. Then Diphortine® was added to the collagen-based dermal substitute at different times during the Nexobrid® treatment and digestion documented.
Results: In the experimental set-up, we found a partial inhibition of NexoBrid® activity at the distinct pH values of 3 and 11. Diphortine® did not inhibit Nexobrid treatment. Instead it was able improve the enzymatic digestion activity after acid burns through raising the pH level.
Conclusion: Diphotrine® was able to effectively change the pH level which lead to an increased enzymatic activity and an improved digestion of the collagen-based dermal substitute. Although clinical studies still have to follow, it seems that rinsing chemical burns with Diphotrine® could enable an effective enzymatic debridement with Nexobrid®.
Dr. Jennifer Schiefer is working as a Consultant in the clinic for plastic and reconstructive surgery, Handsurgery and Burn Care Center in Cologne Merheim. Since working as a doctor she has focussed on trying to minimize patients scarring and optimize burn wound treatment.
Different clinical studies have been published. Especially pure natural silk is an underestimated cheap product that can be used easily in the treatment of superficial burn injuries avoiding painful dressing changes.
Since not many burn centers use this material I wanted to present our experiances with this product.