Enzymatic Debridement Compared To Surgical Debridement: A Cost Analysis in a Burn Unit in Spain.

Abstract

The standard care for burns is tangential surgical debridement and subsequent covering, but recently enzymatic debridement has appeared as an alternative. The objective of this study, using an individualised cost-per-patient information system, is to compare the cost per patient of these two alternatives and identify their main determining factors. A non-randomised, retrospective, observational study was carried out with 79 patients, 39 of whom were treated with surgical debridement. The average cost per patient for enzymatic debridement is lower, particularly due to a shorter length of stay of critical hospitalisation (13.7 vs. 18.9 days; €26,101 vs. €33,919), a decreased need for surgical procedures (0.45 vs. 1.28) and a shorter use of operating theatres (53 vs. 202 minutes; €904 vs. €3,000). Age, aetiology, evolution length and percentage TBSA are robust determinants of the cost of care for burn patients. The type of procedure does not appear to significantly affect the cost per patient.