title: Debriding effect of bromelain on firearm wounds in pigs.
abstract: BACKGROUND
  Wound excision is the standard treatment for firearm wounds. However, achieving a satisfactory curative effect is difficult because of the traumatic mechanism of high-velocity projectiles. We propose a new therapy by using topical bromelain as a supplement to wound incision for the debridement of firearm wounds. We clarified the debriding effect of bromelain on firearm wounds in pigs.
  
  
  METHODS
  In vitro, muscle tissues around the wound track and normal muscle were incubated in bromelain solutions of different concentrations. Tissue hydrolization was estimated by measuring tissue weight and the release of total amino acids. In vivo, the hind limbs of 15 pigs were wounded with high-velocity projectiles. Five groups were classified as follows: wound excision (E), wound incision (I), bromelain (B), incision + bromelain (IB), and control (C). Debriding effectiveness was estimated using bacterial content, histopathologic examination, and wound healing time.
  
  
  RESULTS
  In vitro, hydrolization of wound tissue was significantly more intensive than that of normal tissue. Bromelain solution (10 mg/mL) hydrolyzed wound tissue rapidly with minimal proteolysis of normal tissue. In vivo, the wound-track bacterial content of group IB was similar to that of group E and was significantly lower than that of groups I, B, and C. The wound healing time of group IB was also shorter.
  
  
  CONCLUSIONS
  Bromelain is effective in the debridement of uncomplicated firearm wounds if used as a supplement to simple wound incision. This new therapy shows notable advantages over conventional surgical debridement as it greatly simplifies the procedures.
authors.affiliation: 6th Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Hu
authors.forename: Ai-Min
authors.initials: AM
authors.lastname: Wang
authors.forename: Si-Yu
authors.initials: SY
authors.lastname: Wu
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.forename: Shuai
authors.initials: S
authors.lastname: Liu
authors.forename: Yuan-Bin
authors.initials: YB
authors.lastname: Gou
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Wang
mesh_terms: D000818:Animals; D001963:Bromelains / Q000627:therapeutic use*; D003646:Debridement / Q000379:methods*; D005260:Female; D008297:Male; D018482:Muscle, Skeletal / Q000293:injuries; D013552:Swine; D013848:Thigh / Q000293:injuries; D014945:Wound Healing / Q000187:drug effects; D014948:Wounds, Gunshot / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology
chemical_list: D001963:Bromelains