Efficacy of enzymatic debridement of deeply burned hands

Indeterminate-Depth Burn Injury—Exploring the Uncertainty

“…53 A recent European consensus statement has also endorsed DGD for the management of thermal burns up to 15% TBSA in adults, including management of circumferential burns, as DGD reduces the incidence of compartment syndrome based on recent evidence. 54 Some drawbacks of DGD are severe pain after application, which may be mitigated by analgesics, and difficulty maintaining occlusive dressings on wounds in areas such as the perineum. NexoBrid is in phase III clinical trials in the United States.…”

Natural actives for wound healing: A review

“…Local application of bromelain has been shown to be rapid, effective, non-invasive, safe, easily performed at the bedside with minimal or no blood loss and negligibly interfere with natural wound healing processes (Koller, Bukovcan, Orsag, Kvalteni, & Graffinger, 2008;Muhammad & Ahmad, 2017). Bromelain also accelerates the healing of burn wounds in humans (Krieger et al, 2012), showing antioxidant and antimicrobial activities (Ataide, de Carvalho, et al, 2017;Ali, Milala, & Gulani, 2015;Dutta & Bhattacharyya, 2013;Praveen et al, 2014;Manosroi, Chankhampan, Pattamapun, Manosroi, & Manosroi, 2014).…”

“…Commercial enzymatic debriding agents are available, and some previous studies reported their efficacy mainly in the treatment of burn wounds (Cordts et al, 2016;Rosenberg et al, 2014;Schulz et al, 2017) and to clear bruises and hematomas on boxers (Blonstein, Bromelain (Dutta & Bhattacharyya, 2013;Ali et al, 2015;Praveen et al, 2014;Manosroi et al, 2014;Ataide, de Carvalho, et al, 2017;Ekambaram et al, 2017) (Dutta & Bhattacharyya, 2013;Hu et al, 2011;Singer et al, 2010;Wu et al, 2012) (Blonstein, 1960;Cordts et al, 2016;Koller et al, 2008;Krieger et al, 2012;Rosenberg et al, 2004;Rosenberg et al, 2014;Schulz et al, 2017) Propolis ( Centella asiatica (Hong et al, 2005;Shukla, Rasik, Jain, et al, 1999;Gohil et al, 2010;Incandela et al, 2001;Zhang et al, 2016) (Shukla, Rasik, Jain, et al, 1999;Sawatdee et al, 2016;Gohil et al, 2010;Gul Satar et al, 2013;Sunilkumar et al, 1998;Rosen et al, 1967;Incandela et al, 2001;Poizot & Dumez, 1978;Suguna et al, 1996;Zhang et al, 2016) …”

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

“…Currently available non‐surgical debridement agents, either enzymatic (eg, collagenase) or autolytic (eg, medicinal honey), are slow‐acting, and there is little evidence to suggest that the use of any currently available debridement agent for chronic wounds is beneficial for wound healing when compared with traditional (saline soaking) or other control treatments. Bromelain‐based debridement (BBD), performed with a concentrate of proteolytic enzymes enriched in bromelain (MediWound Ltd, Yavne, Israel), has been proven to be a rapid, efficient, and safe enzymatic debridement agent in burns, with the additional benefit of selectivity, that is, removal of non‐viable tissue and preservation of viable tissue . In light of the unmet need for a rapid and effective non‐surgical debridement agent for chronic wounds and these positive results using BBD for burn eschar removal, 2 similar consecutive concept validation studies were conducted to provide a first impression of the safety and efficacy of BBD in chronic wounds.…”