A Questionnaire-Based Study to Obtain a Consensus from 5 Polish Burns Centers on Eschar Removal by Bromelain-Based Enzymatic Debridement (Nexobrid(®)) in Burns Following the 2020 Updated European Consensus Guidelines

BACKGROUND: The supplementary treatment of burns with enzymatic debridement with Nexobrid(®) was approved in Europe in 2013. The 2017 European consensus guidelines on the removal of eschar in burns by bromelain-based enzymatic debridement were updated in 2020. This questionnaire-based study aimed to obtain a consensus from 5 Polish burns centers on eschar removal by Nexobrid(®) in burns following the 2020 updated European consensus guidelines. MATERIAL/METHODS: A panel of 5 experts representing the leading burn treatment centers in Poland (Cracow, Gryfice, Siemanowice Śląskie, Poznań, and Łęczna) was convened. A modified Delphi process was implemented with panel member selection, literature review, 2 rounds of voting in which panelists were asked to evaluate the European consensus and Polish consensus building by data analysis, statements preparation, final voting, and manuscript drafting. RESULTS: The knowledge and experience of experts from Poland’s leading burn centers resulted in the development of guidelines, formulated as 24 statements representing the following areas: indications and usage, pain management, application principles, post-enzymatic debridement wound dressing, and early and long-term outcomes. An analysis of the 7-point Likert scale polls revealed that 23 of the 24 statements achieved 100% consensus. CONCLUSIONS: The findings from this survey from 5 major centers in Poland supported the main recommendations from the 2020 updated European consensus guidelines on the removal of eschar in burns by Nexobrid(®) and may serve as a practical guide for surgeons who care for patients with burns in this country.