Bromelain‐based enzymatic debridement of chronic wounds: A preliminary report

Abstract

Sharp debridement is currently considered most effective for debridement of chronic wounds; however, some patients do not have access to or cannot be treated by surgical methods. This study was designed to provide a first impression of the safety and efficacy of bromelain-based enzymatic debridement of chronic wounds. Two consecutive single-arm studies assessing the enzymatic debridement efficacy of a concentrate of proteolytic enzymes enriched in bromelain in chronic wounds was conducted in 2 medical centres. Patients were treated with up to 11 consecutive 4-hour enzymatic debridement sessions and then treated until wound closure. Twenty-four patients with chronic wounds of different aetiologies were enrolled. All wounds achieved an average of 68% ± 30% debridement in an average of 3.5 ± 2.8 enzymatic debridement 4-hour sessions. Seventeen responding wounds (venous, diabetic, pressure, and post-traumatic aetiologies) achieved an average 85% ± 12% debridement in 3.2 ± 2.5 applications. Seven non-responding wounds (arterial and post-surgical aetiologies) achieved an average 26% ± 13% debridement in 4.3 ± 3.5 applications. No treatment-related serious adverse events were observed, and the only adverse event attributed to the enzymatic debridement was pain. These preliminary results indicate the potential safety and efficacy of bromelain-based enzymatic debridement in chronic wounds. Larger controlled studies are needed to further investigate this indication.

Efficacy of proteolytic enzyme bromelain on health outcomes after third molar surgery. Systematic review and meta-analysis of randomized clinical trials

“…Reports from preliminary clinical studies have indicate the potential safety and efficacy of bromelain-based enzymatic debridement in chronic wounds(6) and deep burn injuries (7). In addition, reports have shown that anti-inflammatory and analgesic characteristics of bromelain could be useful in the treatment of several chronic inflammatory disorders as osteoarthritis and rheumatoid arthritis (8–10).…”

3D‐Printed Hydrogel‐Filled Microneedle Arrays

“…[ 31c,33 ] Since, upon injury, the skin barrier is breached, it has been believed that the topical delivery of drugs would allow their proper penetration and distribution. However, the formed eschar, a crust of necrotic tissue that dries and hardens postinjury, [ 34 ] combined with exudate flow rich with various enzymes can lower the bioavailability of topically delivered compounds to the target cells. It has recently been shown that the intradermal delivery of therapeutics is superior to topically delivery for improving diabetic wound healing, [ 31c ] and there is growing interest in the use of MNAs to treat these kinds of wounds.…”

Effizienzsteigerung und Kostenreduktion durch Straffung der Wundversorgung von chronischen Wunden in einem Klinikverbund mit 16 Kliniken

“…Wachstumsfaktoren die Wundheilung fördern sollen. Die Evidenz zu diesen Präparaten ist jedoch mäßig [13] (▶ Abb. 3).…”