title: Minimally invasive burn care: a review of seven clinical studies of rapid and selective debridement using a bromelain-based debriding enzyme (Nexobrid®).
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%], P0.001). 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.
authors: Department of Plastic and Reconstructive Surgery and the burn Unit, Soroka University medical Centre, Faculty of health Sciences, ben-Gurion University, beer-Sheva, israel; Cleft Lip and Palate and Craniofacial Deformities Unit, Department of Plastic Surgery, meir hospital, kfar Saba, israel; Clinical and medical Departments, mediWound LTD, Yavneh, israel.
authors: L
authors: L
authors: Rosenberg
authors: Department of Plastic and Reconstructive Surgery and the burn Unit, Soroka University medical Centre, Faculty of health Sciences, ben-Gurion University, beer-Sheva, israel.
authors: Y
authors: Y
authors: Shoham
authors: Department of Plastic and Reconstructive Surgery and the burn Unit, Soroka University medical Centre, Faculty of health Sciences, ben-Gurion University, beer-Sheva, israel.
authors: Y
authors: Y
authors: Krieger
authors: Department of orthopedics, haemek hospital, Afula, israel.
authors: G
authors: G
authors: Rubin
authors: Unfallkrankenhaus berlin, Centre for Severe burns with Plastic Surgery, berlin, Germany.
authors: F
authors: F
authors: Sander
authors: Department of Plastic Surgery and burn Unit, University hospital, bratislava, Slovakia.
authors: J
authors: J
authors: Koller
authors: Clinical and medical Departments, mediWound LTD, Yavneh, israel.
authors: K
authors: K
authors: David
authors: Department of Plastic and Reconstructive Surgery and the burn Unit, Rambam hospital, haifa, israel.
authors: D
authors: D
authors: Egosi
authors: Department of burns and Plastic Surgery, Lok nayak hospital and maulana Azad medical College, new Delhi.
authors: R
authors: R
authors: Ahuja
authors: Department of emergency medicine, Stony brook University, Stony brook, nY.
authors: A J
authors: AJ
authors: Singer
keywords: DGD; NexoBrid®; burns; debriding gel dressing; enzymatic debridement; enzymatic escharotomy