WE SEE THE CHALLENGE OF REMOVING ESCHAR AND REVEALING BURN DEPTH

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Starting your patients on their course to healing AFTER A THERMAL BURN INCIDENT begins with timely, effective eschar removal to prepare an optimal wound bed.1,2

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Accurate determination of burn depth is one of the most important decisions in burn care, predicting healing and enabling a clearer path for clinical decision making.1,3

Timely assessment and treatment of burns, as well as early wound closure, may lead to improved morbidity and mortality, as well as shorter hospital stays3,4

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Assessment of burn depth using standard methods of care continues to present challenges—even to experts.

  • The extent of excision is determined based on visual presence of bleeding of the viable wound bed, which may not always be accurate1
  • The color and texture of eschar may be misleading and burn depth may not be consistent within the damaged area5
  • Data has shown that the assessment of burn depth is only accurate up to 75% of the time, even when performed by experienced burn clinicians3
  • Accurate assessment of mixed-depth burns can be the most challenging because it can take up to 2 weeks to diagnose indeterminate burn depth and begin eschar removal1
 

Surgeons have limited nonsurgical tools to assess the depth of deep-partial or full-thickness burns. As a result, excision often leads to the removal of viable tissue, which could lead to greater blood loss.1,3

While surgical excision is effective, it can involve trauma, potential damage to viable tissue, and blood loss1,5

Surgical burn debridement affecting viable tissue 57% 87%

One study found that blood loss during surgical excision was significantly underestimated to between 57% to 87% of the calculated blood loss,6 which can distort the severity of the injury and further complicate the clinical decision-making process7

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There is an unmet need for a nonsurgical approach to eschar removal that is safe, selective, timely, and effective.1

  • Alternative methods to achieving early eschar removal while preserving viable tissue are a priority in burn care1,3

  • Nonsurgical eschar removal may help avoid injury to viable tissue including nerves, vessels, tendons, and muscles, as well as reduce blood loss

  • Currently available nonsurgical methods of eschar removal have limited effectiveness and efficiency in clinical practice1

Podcast: The Challenge of Wound Assessment in Severe Bruns
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Vericel is committed to helping address challenges with eschar removal

References:
  1. Rosenberg L. Enzymatic debridement of burn wounds. Total Burn Care. 2012:131-135. doi: 10.1016/B978-1-4377-2786-9.00011-4
  2. Rowan MP, Cancio LC, Elster EA, et al. Burn wound healing and treatment: review and advancements. Crit Care. 2015;19(1):1-12. doi: 10.1186/s13054-015-0961-2
  3. Singer A, Boyce S. Burn wound healing and tissue engineering. J Burn Care Res. 2017;38(3):e605-e613. doi: 10.1097/BCR.0000000000000538
  4. Lee JO, Dibildox M, Jimenez CJ, et al. Operative wound management. Total Burn Care. 2012:157-158. doi: 10.1016/B978-1-4377-2786-9.00011-8
  5. Gurfinkel R, Rosenberg L, Cohen S, et al. Histological assessment of tangentially excised burn eschars. Can J Plast Surg. 2010;18(3):e33-e36.
  6. Luo G, Fan H, Sun W, et al. Blood loss during extensive escharectomy and auto-microskin grafting in adult male major burn patients. Burns. 2011;37:790-793. doi: 10.1016/j.burns.2011.01.021
  7. Ashburn JC, Harrison T, Ham JJ, Strote J. Emergency physician estimation of blood loss. West J Emerg Med. 2012;13(4)376-379. doi: 10.5811/westjem.2011.9.6669
  8. Evolving challenges in eschar removal in the treatment of severe burns. A roundtable discussion with Jeremy Goverman, MD, William Hickerson, MD, and Steven Kahn, MD. Published 2021. https://www.redefiningdebrideme nt.com/signupnow/