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Ann Burns Fire Disasters. 2017 Sep 30;30(3):198-204.

Bromelain-based enzymatic debridement and minimal invasive modality (mim) care of deeply burned hands.

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Department of Plastic Surgery and Burn Unit, Soroka Medical Center, The Ben-Gurion University of the Negev, Beer Sheva, Israel.
Orthopedic Department, Emek Medical Center, Afula / Faculty of Medicine, Technion, Haifa, Israel.
Klinik für Plastische Chirurgie, Handchirurgie - Schwerbrandverletztenzentrum - Krankenhaus Merheim, Lehrstuhl für Plastische Chirurgie der Universität Witten/Herdecke, Köln, Germany.
Cleft Lip & Palate & Craniofacial Deformities Unite, Department of Plastic Surgery, Meir Hospital Kfar Saba, Israel / MediWound Ltd. Israel.
Department of Emergency Medicine, Stony Brook University, Stony Brook, NY, USA.


in English, French

The objective was to critically review the data and assess the implications of NexoBrid [NexoBrid-NXB formerly Debrase Gel Dressing-DGD]a in the special field of deep hand burns. Detailed analysis of endpoints in the treatment of hand burn patients was conducted as part of a multi-center, open label, randomized, controlled two-arm study to evaluate the safety and efficacy of NXB enzymatic debridement, comparing it to the current standard of care (SOC). These results were compared to a large cohort of patients treated with NXB in a previous, single arm study. Thirty-one burned hands were treated with NXB and 41 hand burns were in the SOC group. In the NXB group, 4 out of 31 hand burns (12.9%) required some excisional debridement compared to 29 out of the 41 (70.7%) in the SOC group (p<0.0001). Mean percentage of burn wound area excised in the NXB group was 4.4 ± 13.1% compared to 52.0 ± 41.4% in the SOC group (p<0.0001). None of the NXB-treated hands required escharotomy compared to 4 out of the 41 (9.7%) in the SOC group. NXB enzymatic debridement demonstrated a statistically significant reduction in burn wound excision and auto-grafting compared to SOC, and seems to prevent the need for emergency escharotomy. a DGD is produced by MediWound and distributed under the name NexoBrid®.


MIM,; burns; enzymatic debridement; enzymatic escharotomy; enzymatic surgery; eschar removal; hands; minimally invasive modality of burn care


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