title: Selectivity of a bromelain based enzymatic debridement agent: a porcine study.
abstract: BACKGROUND
  Debridement of the burn eschar is a cornerstone of burn wound care. Rapid enzymatic debridement with a bromelain-based agent (Debriding Gel Dressing-DGD) has recently been investigated. The current study was designed to further investigate the selectivity of DGD to burned eschar in a larger number and more varied types of wounds.
  
  
  METHODS
  A systematic animal experiment was conducted to determine the effects of DGD on normal, non-injured skin, burns, exposed dermis of donor sites, and skin punch biopsy wells. Partial thickness dermal burns and partial thickness skin graft donor sites were created on a pig and treated with a 4-h application of DGD or its control hydrating vehicle that does not have any activity except hydration. Punch biopsy samples were taken before and after treatment and microscopically assessed for evidence of tissue viability and its respective components thickness.
  
  
  RESULTS
  Rapid dissolution of the burn eschar was noted in all DGD but not vehicle treated burns. There was no apparent damage to the underlying sub eschar dermis, donor sites, normal skin or punch biopsy wells after exposure to DGD. While the thickness of the treated tissues slightly increased due to edema, the increase in dermal thickness was similar after treatment with DGD or its vehicle. The increase in the cross section surface area of the treated punch biopsy wells was similar after treatment with DGD and its control vehicle.
  
  
  CONCLUSIONS
  Exposure of the burn eschar to DGD results in its rapid dissolution. Exposure of normal skin or non-burned dermis to DGD has no effects demonstrating its selectivity to eschar.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ben Gurion Health Sciences Faculty, Ben-Gurion University, Beer-Sheba, Israel.
authors.forename: Lior
authors.initials: L
authors.lastname: Rosenberg
authors.forename: Yuval
authors.initials: Y
authors.lastname: Krieger
authors.forename: Eldad
authors.initials: E
authors.lastname: Silberstein
authors.forename: Ofer
authors.initials: O
authors.lastname: Arnon
authors.forename: Igor A
authors.initials: IA
authors.lastname: Sinelnikov
authors.forename: Alex
authors.initials: A
authors.lastname: Bogdanov-Berezovsky
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Singer
mesh_terms: D000279:Administration, Cutaneous; D000818:Animals; D047070:Bandages, Hydrocolloid; D001963:Bromelains / Q000627:therapeutic use*; D002056:Burns / Q000473:pathology / Q000628:therapy*; D003646:Debridement / Q000379:methods*; D004195:Disease Models, Animal; D057487:Enzyme Therapy; D005260:Female; D011446:Prospective Studies; D016038:Skin Transplantation; D034421:Sus scrofa; D014945:Wound Healing; D014947:Wounds and Injuries / Q000628:therapy*
chemical_list: D001963:Bromelains