title: Safety and efficacy of a proteolytic enzyme for enzymatic burn debridement: a preliminary report.
abstract: A prospective, non-comparative study design was used to describe our experience with a bromelain-derived debriding agent, Debridase, in 130 patients with 332 deep second degree and third degree burns treated between 1984 and 1999. Debridase was applied after saturating the burns with a moist dressing for 2-24h. Debridase was applied for a period of 4h under an occlusive dressing. Mean patient age was 18.6 +/- 19.3, 42 (32.3%) were female, and 63 (48.5%) were children under age 18. Most burns were small. Debridase was applied once in 241 (72.6%) of the 332 wounds, twice in 67 (20.18%) cases, three times in 12 (3.61%) cases, and four times in 2 (0.6%) cases. The percentage debridement by number of applications was 89 +/- 21% for a single application, 77 +/- 27% for two, and 62 +/- 27% for three Debridase applications, respectively. There were no significant adverse events. The availability of a fast acting, reliable and complication-free enzymatic debriding agent may open new horizons and provide a new treatment modality for burns.
authors.affiliation: Department of Plastic and Reconstructive Surgery, and the Burn Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel, POB 151, Beer-Sheva 84101, Israel. proflior@netvision.net.il
authors.forename: Lior
authors.initials: L
authors.lastname: Rosenberg
authors.forename: Oren
authors.initials: O
authors.lastname: Lapid
authors.forename: Alex
authors.initials: A
authors.lastname: Bogdanov-Berezovsky
authors.forename: Ronen
authors.initials: R
authors.lastname: Glesinger
authors.forename: Yuval
authors.initials: Y
authors.lastname: Krieger
authors.forename: Eldad
authors.initials: E
authors.lastname: Silberstein
authors.forename: Amiram
authors.initials: A
authors.lastname: Sagi
authors.forename: Keith
authors.initials: K
authors.lastname: Judkins
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Singer
mesh_terms: D000293:Adolescent; D000328:Adult; D001963:Bromelains / Q000009:adverse effects / Q000627:therapeutic use*; D002056:Burns / Q000503:physiopathology / Q000601:surgery*; D003646:Debridement / Q000379:methods*; D005260:Female; D006801:Humans; D007641:Keratolytic Agents / Q000627:therapeutic use*; D008297:Male; D009779:Occlusive Dressings; D011446:Prospective Studies; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D007641:Keratolytic Agents; D001963:Bromelains