Minimally invasive burn care: A review of seven clinical studies of rapid and selective debridement using a bromelain-based debriding enzyme (NexoBrid®)

L. Rosenberg, Y. Shoham, Y. Krieger, G. Rubin, F. Sander, J. Koller, K. David, D. Egosi, R. Ahuja, A. J. Singer

Research output: Contribution to journalArticlepeer-review

74 Scopus citations

Abstract

Current surgical and non-surgical eschar removal-debridement techniques are invasive or ineffective. A bromelainbased rapid and selective enzymatic debriding agent was developed to overcome these disadvantages and compared with the standard of care (SOC). The safety and efficacy of a novel Debriding Gel Dressing (DGD) was determined in patients with deep partial and full thickness burns covering up to 67% total body surface area (TBSA). This review summarizes data from seven studies, four of which were randomized clinical trials that included a SOC or control vehicle. DGD eschar debridement efficacy was >90% in all studies, comparable to the SOC and significantly greater than the control vehicle. The total area excised was less in patients treated with DGD compared with the control vehicle (22.9% vs. 73.2%, P<0.001) or the surgical/non-surgical SOC (50.5%, P=0.006). The incidence of surgical debridement in patients treated with DGD was lower than the SOC (40/163 [24.5%] vs. 119/170 [70.0%], P<0.001). Less autografting was used in all studies. Long-term scar quality and function were similar in DGD- and SOCtreated. DGD is a safe and effective method of burn debridement that offers an alternative to surgical and non-surgical SOC.

Original languageEnglish
Pages (from-to)264-274
Number of pages11
JournalAnnals of Burns and Fire Disasters
Volume28
Issue number4
StatePublished - 1 Dec 2015
Externally publishedYes

Keywords

  • Burns
  • DGD
  • Debriding gel dressing
  • Enzymatic debridement
  • Enzymatic escharotomy
  • NexoBrid®

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Critical Care and Intensive Care Medicine

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