A Clinical Study of Role of Enzymatic Debriding Agent Papain Urea Cream in the Management of Deep Burn Wounds.

Many agents have been used in the past but none of them have been thoroughly evaluated. The present study was undertaken to assess the efcacy of papain urea cream, a commonly available debriding agent with papain and urea as its constituents. Materials &Methods:- A clinical prospective observational study Patients with deep burn wounds were selected and divided into two groups , one group was dressed with 1% silver sulfadiazine cream and Vaseline dressing and the other group of patients was dressed with combination of papain urea cream on deep burn wounds & supercial burn wounds were treated with 1%SSD/Nanocrystaline silver cream. The wound dressing was changed everyday after proper bathing with fresh tap water and followed by normal saline. Wound parameters were assessed regularly , using clinical methods and photographs. The obtained data were statistically analyzed and results produced. Results:In our study, most patients were noted to have early separation of slough , decreased blood loss, less painful, less number of surgical debridement , early skin grafting following dressing with papain urea on deep burn wounds & SSD/Nanocrystaline silver combination (PUC group) when compared to 1% silver sulfadiazine cream with Vaseline (SSD) group. The mean hospital stay was less in of patients who were undergoing dressing with papain urea on deep burn wounds & SSD/Nanocrystaline silver combination(PUC group) when compared to 1% silver sulfadiazine cream and Vaseline group (SSD group) . The papain urea Conclusions: cream on deep burn wounds & SSD/Nanocrystaline silver on supercial burn wounds combination resulting in early & easy separation of slough from wound bed , early preparation of wound for grafting & thereby decreasing hospital stay has been estabilshed. Considering the above ndings papain urea is more recommended to be used for deep burn wounds for enzymatic debridement.