Hilal Bahia1, Jeanna Bernard1, Dr Jenna Langschymidt1, Daniel Widdowson1
Introduction: Nexobrid is a bromelain based enzymatic agent of plant origin licensed for use in the treatment of deep partial and full thickness burns. Nexobrid is capable of selectively removing burn eschar within 4 hours without the need for a general anaesthetic thereby providing a minimally invasive alternative to burn debridement. Our aim was to review the clinical effects/benefits of using this modality of treatment in our burn unit.
Method: We carried out a retrospective analysis of the case notes of 40 patients undergoing Nexobrid treatment. We recorded information including: demographics, total body surface area affected, type of burn, burn depth, time to Nexobrid application, pain scores before, during and after treatment, anaesthesia given, need for surgical debridement following Nexobrid treatment, length of hospital stay, cost of treatment, time to healing and wound microbiology.
Results: None of our patients experienced a significant complication to treatment. Nexobrid debridement was effective in 37/40 cases. Additional benefits of Nexobrid included a reduction in over debridement in anatomically challenging areas, minimal blood loss and potentially reduced hospital admissions.
Conclusion: We have found Nexobrid to be safe and effective in adequately debriding deep partial and full thickness burns. In our selected patients Nexobrid was found to reduce the need for surgical debridement under a general anaesthetic and its associated morbidities. Many have avoided skin grafting due to preservation of the dermis. The selected use of this product may significantly alter the acute management of partial and full thickness burn injuries.