Review
Surgery
Nikolaos Arkoulis, Nigel Tapiwa Mabvuure, Alex Smith, David E. Barnes
Summary: The study presented the early experience of using NexobridTM at a tertiary burns center between July 2016 and December 2019. It assessed whether NXB had changed the acute care delivered to the cohort. Results showed that NXB was successful in debriding burnt tissue in 55% of patients, reducing the need for escharotomy in some cases. Further surgery was required for 60% of patients, with 80% of facial burns treated with NXB requiring additional surgery.
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
(2021)
Article
Medicine, General & Internal
Christian Tapking, Victoria G. Rontoyanni, Yannick F. Diehm, Felix Struebing, Farzan Solimani, Amir K. Bigdeli, Gabriel Hundeshagen, Sebastian Fischer, Ulrich Kneser, Laura C. Siegwart
Summary: The efficacy of enzymatic debridement (ED) in geriatric burn patients was evaluated in this study. A total of 169 patients in the younger and geriatric groups were included, and it was found that ED had similar efficacy in both groups, but the geriatric group had a higher surgical risk. Therefore, ED is a reliable and safe treatment option for geriatric burn patients.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Biology
Andrey A. Alekseev, Natalia B. Malyutina, Alexander E. Bobrovnikov, Yaron Shoham
Summary: Since its approval in Europe, NexoBrid enzymatic debridement has become a widely accepted standard practice for deep thermal burns treatment worldwide. This study reports the first experience with NexoBrid in the Russian Federation, showing successful eschar removal and spontaneous wound healing in most patients. The early use of NexoBrid resulted in rapid, effective, and safe treatment outcomes.
Review
Dermatology
Yaron Shoham, Konstantinos Gasteratos, Adam J. Singer, Yuval Krieger, Eldad Silberstein, Jeremy Goverman
Summary: In 2012, a pineapple stem-derived Bromelain-based debridement concentrate (NexoBrid & REG;, MediWound Ltd, Yavne, Israel) was approved by the European Medicines Agency for adult deep burns. A systematic review of the literature on Nexobrid & REG; outcomes was conducted, identifying 103 relevant studies, of which 34 were eligible. The studies reported positive effects of Nexobrid & REG; on burn debridement, functional and cosmetic outcomes, scarring, and quality of life, indicating its safety and benefits as a non-surgical eschar removal treatment.
INTERNATIONAL WOUND JOURNAL
(2023)
Article
Critical Care Medicine
Amal Sharaf, Preetha Muthayya
Summary: This study examines the effect of bromelain-based enzymatic debridement using NexoBrid(R) gel on the microbiological pattern of burn wounds, and finds that it is similar to cases treated without enzymatic debridement.
Article
Critical Care Medicine
Rosario Ranno, Michelangelo Vestita, Giulio Maggio, Pasquale Verrienti, Davide Melandri, Catuscia Orlandi, Giuseppe Perniciaro, Armando De Angelis, Roberto D'Alessio, Ilaria Mataro, Eliana Pagnozzi, Giovanni Alessandro, Edoardo Caleffi, Antonio Di Lonardo, Serena Ciappi, Paolo Palombo, Maria Alma Posadinu, Maurizio Stella, Mariarosa Romeo, Jasminka Minic, Maurizio Governa, Giuseppe Giudice
Summary: Italian experts have provided recommendations on the use of Nexobrid (R), an enzymatic debridement, in burn surgery. Through a multi-phase process based on the Delphi method, experts reached consensus on the majority of statements, providing a valuable set of recommendations for clinicians. These recommendations are specific to the Italian experience and will be updated as new evidence becomes available.
Article
Critical Care Medicine
Jiaxin Wen, Kirsty Johnson, Ciaran P. O'Boyle
Summary: This study investigates the feasibility of using human cadavers to demonstrate enzymatic burn debridement for training clinical staff. The findings suggest that fresh-frozen human cadaveric tissue is a valid means of training in this technique.
Article
Critical Care Medicine
Lisanne Grunherz, Ramona Michienzi, Claudine Schaller, Daniel Rittirsch, Semra Uyulmaz, Bong - Sung Kim, Pietro Giovanoli, Nicole Lindenblatt
Summary: It has been shown that Nexobrid(R) is a safe and effective method for debriding deep burns and reducing the need for surgical escharotomy. However, there is limited evidence for its use in larger body areas. This retrospective study found that the use of Nexobrid(R) for preventive decompression was less common but had a lower mortality rate compared to surgical escharotomy.
Article
Chemistry, Multidisciplinary
Mihaela Pertea, Vladimir Poroch, Petru Ciobanu, Alexandru Filip, Natalia Velenciuc, Sorinel Lunca, Andrian Panuta, Mihaela Buna-Arvinte, Stefana Luca, Bogdan Veliceasa
Summary: The study aimed to evaluate the use of bromelain in deep burns and found that it has certain advantages in removing eschar. However, early excision followed by coverage with split-thickness skin graft remains the gold standard for the treatment of deep burns.
APPLIED SCIENCES-BASEL
(2021)
Article
Medicine, Research & Experimental
Tomasz Korzeniowski, Jerzy Struzyna, Anna M. Chrapusta, Andrzej Krajewski, Marek Kucharzewski, Krzysztof Piorun, Jakub Nowakowski, Agnieszka Surowiecka, Magdalena Kozicka, Kamil Torres
Summary: This questionnaire-based study obtained consensus from 5 Polish burns centers on using Nexobrid (R) for eschar removal in burns. The findings supported the main recommendations from the 2020 updated European consensus guidelines and may serve as a practical guide for surgeons in Poland.
MEDICAL SCIENCE MONITOR
(2022)
Article
Cell Biology
Yaron Shoham, Eyal Shapira, Josef Haik, Moti Harats, Dana Egozi, Dror Robinson, Leonid Kogan, Rania Elkhatib, Geza Telek, Avshalom Shalom
Summary: Chronic wounds affect over 6 million people annually in the US, with an estimated annual cost of $25 billion. Debridement is crucial for tissue repair, but there is a need for non-surgical debridement agents. EscharEx, a bromelain-based enzymatic debridement agent, has shown to be effective and safe in chronic wounds.
WOUND REPAIR AND REGENERATION
(2021)
Article
Medicine, General & Internal
Tomasz Korzeniowski, Ewelina Grywalska, Jerzy Struzyna, Magdalena Bugaj-Tobiasz, Agnieszka Surowiecka, Izabela Korona-Glowniak, Magdalena Staskiewicz, Kamil Torres
Summary: This study aimed to compare the demographic characteristics, surgical treatment, and outcomes of patients treated with Nexobrid(R) and patients who had standard surgical excision. The results showed that enzymatic debridement effectively removed burn eschar without adverse reactions or serious complications. The relative risk of reconstructive procedures was reduced in patients treated enzymatically.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Critical Care Medicine
Pablo Pfister, Pedro David Garcia Wendel, Bong Sung Kim, Reto Andreas Schuepbach, Peter Steiger, Giovanni Camen, Philipp Karl Buehler
Summary: This study compared the effects of enzymatic and surgical debridement on coagulation in burn patients. The results showed that enzymatic debridement did not increase the risk of coagulation abnormalities compared to the standard surgical approach.
Article
Critical Care Medicine
C. Bowers, A. Randawa, B. Sloan, U. Anwar, A. Phipps, P. Muthayya
Summary: Research on the use of bromelain-based enzymatic debridement in larger burn injuries has shown significant advantages such as reduced blood loss, improved dermal preservation, decreased need for autografting, and fewer surgical procedures. It is recommended that both the medical team and patients be prepared for enzymatic debridement in large burn injuries and establish robust local pathways prior to use.
Article
Biochemistry & Molecular Biology
Brian Michael Cartwright, Sean James Fox, Mary Jane Underdown, William Andrew Clark, Joseph Andrew Molnar
Summary: Current treatments for deep tissue burns are limited, often relying on slow natural processes for wound healing. Infections, which can disrupt the healing process, are a major concern. This study introduces ARAG, an antioxidant-rich antimicrobial gel, which can effectively suppress the growth of bacteria commonly found in burn infections. The findings also demonstrate that ARAG promotes enhanced wound healing compared to the current standard of care, Mepilex-Ag, likely due to increased wound debridement and reduced inflammation.