title: Sharp wound debridement in local anaesthesia using EMLA cream: 6 years' experience in 1084 patients.
abstract: Sharp debridement is the most efficient method for clearing the woundbed in the exudation and granulation phase of wound healing. At our clinic the anaesthetic lidocaine-prilocaine cream, EMLA, has been used as an analgesic for sharp debridement since 1994. A review of patients' records was conducted, including ulcer size, dose of cream used, analgesic efficacy and complications. During a 6-year period a total of 1084 patients were treated for leg ulcers, decubitus ulcers, abscess revisions, anal and coccyx fistulae, postoperative wounds, diabetic ulcers and burns. Doses ranging from 3 to 150 g cream were applied for 45-60 min. In all patients except three the analgesia was adequate for debridement. We observed no allergic reactions, no clinical symptoms of local anaesthetic toxicity or methaemoglobinaemia. In 12 patients (1.1%) a burning sensation was reported directly after the application of EMLA cream to the ulcer, which, however, subsided within 15-20 min. In our experience, sharp debridement in percutaneous analgesia with EMLA is efficient, economical, safe, and tolerable for the patient.
authors.affiliation: Department of Traumatology and Plastic Surgery, Elbe-Klinikum, Stade, Germany.
authors.forename: Walter
authors.initials: W
authors.lastname: Blanke
authors.forename: Bernd V
authors.initials: BV
authors.lastname: Hallern
mesh_terms: D019162:Anesthetics, Combined / Q000627:therapeutic use*; D003646:Debridement / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007871:Leg Ulcer / Q000503:physiopathology / Q000628:therapy*; D008012:Lidocaine / Q000627:therapeutic use*; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments / Q000627:therapeutic use*; D011318:Prilocaine / Q000627:therapeutic use*; D014945:Wound Healing / Q000502:physiology
chemical_list: D019162:Anesthetics, Combined; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine