Enzymatic frostbite eschar debridement by bromelain

Area of Science:

• Biochemistry
• Wound Healing
• Dermatology

Background:

• Bromelain, a pineapple-derived protease, is effective for debriding burn eschar.
• Its potential for frostbite eschar removal requires investigation.

Purpose of the Study:

• To evaluate bromelain's efficacy in debriding third-degree frostbite eschar.
• To compare bromelain's effect on frostbite eschar versus burn eschar.

Main Methods:

• Third-degree frostbite lesions were induced in swine using supercooled air.
• Resulting eschars were treated with a bromelain preparation.
• Third-degree burn injuries served as controls to validate enzyme efficacy.

Main Results:

• Bromelain debrided only superficial layers of frostbite eschar.
• Burn injuries were effectively debrided to a graftable bed after two enzyme applications.
• Frostbite injuries remained unaffected by bromelain treatment.

Conclusions:

• Bromelain is ineffective for frostbite eschar removal.
• Factors in frostbite injuries, including vasculature, edema, and protein coagulation, inactivate bromelain.
• The enzyme's digestive action is prevented before it can be effective on freeze-injured tissue.