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Ann Burns Fire Disasters · Dec 2015
Minimally invasive burn care: a review of seven clinical studies of rapid and selective debridement using a bromelain-based debriding enzyme (Nexobrid®).
- L Rosenberg, Y Shoham, Y Krieger, G Rubin, F Sander, J Koller, K David, D Egosi, R Ahuja, and A J Singer.
- 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.
- Ann Burns Fire Disasters. 2015 Dec 31; 28 (4): 264-274.
AbstractCurrent 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.
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