ENZYMATIC DEBRIDEMENT IN THERMAL INJURIES: EVIDENCE FROM GERMAN HOSPITAL BILLING DATA
Author(s)
Steffen Wahler, MA, MD1, Christiane Koll, MD2.
1Member, St. Bernward, Hamburg, Germany, 2Diabetes Praxis Blankenese, Hamburg, Germany.
1Member, St. Bernward, Hamburg, Germany, 2Diabetes Praxis Blankenese, Hamburg, Germany.
OBJECTIVES: Enzymatic debridement offers a selective, tissue-sparing approach to wound bed preparation in thermal injuries and is increasingly used alongside established surgical burn care. Evidence on its use under routine inpatient conditions in Germany remains scarce. This study described the patient groups, injury patterns, hospital settings, and resource use associated with enzymatic debridement in German inpatient burn care in 2024.
METHODS: We conducted a retrospective descriptive analysis of nationwide German InEK hospital billing data for 2024. Eligible cases were inpatient admissions with thermal injury diagnoses coded as ICD-10-GM T20-T31 and enzymatic wound management coded as OPS 8-191.70 ff. Extracted variables included age, sex, injury location, affected body surface area, microbiological codes, diagnosis-related group allocation, length of stay, comorbidities, hospital ownership, hospital size, and burn-center status.
RESULTS: A total of 325 inpatient cases involving enzymatic debridement were identified. Children and adolescents represented 34.5% of cases, adults aged 30-49 years 26.8%, and adults aged >65 years 18.8%. Most patients were male (69.5%). Frequently coded injury sites were the hand or forearm (11.7%), hip or leg (10.2%), and head or neck (7.4%). Burns involving less than 10% of body surface area accounted for 51.1% of cases. Microbiological codes included streptococci in 22.9%, other staphylococci in 16.3%, and Staphylococcus aureus in 15.4%. The most common DRGs were Y03Z (28.6%), Y01Z (24.6%), and Y02D (16.3%). Mean length of stay was 22.2 days (SD 26.8). Care was concentrated in public hospitals with more than 500 beds and in designated burn centers.
CONCLUSIONS: In routine German inpatient care, enzymatic debridement is used mainly in male patients, younger age groups, and specialized burn-care settings. The observed DRG distribution and prolonged inpatient stays suggest that enzymatic debridement is embedded in complex burn-care pathways rather than used as an isolated wound-care procedure.
METHODS: We conducted a retrospective descriptive analysis of nationwide German InEK hospital billing data for 2024. Eligible cases were inpatient admissions with thermal injury diagnoses coded as ICD-10-GM T20-T31 and enzymatic wound management coded as OPS 8-191.70 ff. Extracted variables included age, sex, injury location, affected body surface area, microbiological codes, diagnosis-related group allocation, length of stay, comorbidities, hospital ownership, hospital size, and burn-center status.
RESULTS: A total of 325 inpatient cases involving enzymatic debridement were identified. Children and adolescents represented 34.5% of cases, adults aged 30-49 years 26.8%, and adults aged >65 years 18.8%. Most patients were male (69.5%). Frequently coded injury sites were the hand or forearm (11.7%), hip or leg (10.2%), and head or neck (7.4%). Burns involving less than 10% of body surface area accounted for 51.1% of cases. Microbiological codes included streptococci in 22.9%, other staphylococci in 16.3%, and Staphylococcus aureus in 15.4%. The most common DRGs were Y03Z (28.6%), Y01Z (24.6%), and Y02D (16.3%). Mean length of stay was 22.2 days (SD 26.8). Care was concentrated in public hospitals with more than 500 beds and in designated burn centers.
CONCLUSIONS: In routine German inpatient care, enzymatic debridement is used mainly in male patients, younger age groups, and specialized burn-care settings. The observed DRG distribution and prolonged inpatient stays suggest that enzymatic debridement is embedded in complex burn-care pathways rather than used as an isolated wound-care procedure.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH97
Topic
Epidemiology & Public Health
Topic Subcategory
Disease Classification & Coding, Public Health
Disease
Injury & Trauma, Surgery