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Related Concept Videos

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Epidermal stem cells (EpiSCs) are mainly located at the basal layer of the epidermis. These cells repair minor injuries of the skin and replace dead skin cells. However, EpiSCs’ cannot heal severe wounds such as major burns or those from diabetes or hereditary disorders. In such cases, culturing the epidermal stem cells from the patient is possible and has yielded successful treatment options, such as laboratory-grown skin grafts. These grafts are synthesized using a patient’s own...
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Following injury, the integrity of the injured tissues must be reestablished. For example, in skin tissue, wound repair involves coordination among resident skin cells, blood mononuclear cells, extracellular matrix, growth factors, and cytokines to complete the healing cascade.
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Regeneration and repair processes are critical in healing damages caused by injury, disease, and aging. In regeneration, the damaged tissue is entirely replaced with new growth that restores the original architecture and function. In contrast, tissue repair usually results in a fixed tissue architecture involving scar formation. Scars generally do not reestablish tissue function and may also exhibit structural abnormalities at the injury site.
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Matrix metalloproteases (MMPs) are enzymes involved in the hydrolysis of proteins and glycoproteins of the extracellular matrix. MMPs are essential for the migration and proliferation of cells through the dense matrix network, throughout embryonic development, and throughout morphogenesis. The first MMP activity discovered was a collagenase in a tadpole's tail undergoing metamorphosis. The active collagen deposition and modifications lead to the morphogenesis of tadpoles into the adult...
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ASO Visual Abstract: The Added Value of Plastic Surgery in the Multidisciplinary Management of Sarcoma Resection: A Multivariable Analysis of Predictors and Postoperative Outcomes.

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Correction: Rijpma et al. Wound and Short-Term Scar Outcomes of Meek Micrografting Versus Mesh Grafting: An Intra-Patient Randomized Controlled Trial. <i>Eur. Burn J.</i> 2025, <i>6</i>, 26.

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Application of Lucilia sericata Larvae in Debridement of Pressure Wounds in Outpatient Settings
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Enzymatic debridement: past, present, and future.

Ignace De Decker1, Liesl De Graeve2, Henk Hoeksema1,2

  • 1Burn Center, Ghent University Hospital, Ghent, Belgium.

Acta Chirurgica Belgica
|April 20, 2022
PubMed
Summary

Enzymatic debridement, particularly with bromelain-based products like NexoBrid®, offers a selective alternative to surgical debridement for deep burns. Further trials are needed to fully establish its role compared to standard care.

Keywords:
Burnchemical debridementenzymatic debridementnon-surgical debridementtangential excision

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Area of Science:

  • Burn wound management
  • Dermatology
  • Surgical innovation

Background:

  • Surgical debridement is the standard of care for deep burns but has limitations.
  • Enzymatic debridement is emerging as a less invasive alternative.
  • Interest is growing in non-surgical debridement methods.

Purpose of the Study:

  • To provide a historical overview and current state of enzymatic debridement for burns.
  • To evaluate enzymatic debridement as an alternative to surgical debridement.
  • To discuss future perspectives in non-surgical burn wound treatment.

Main Methods:

  • A systematic search of the literature was conducted.
  • A narrative review of 32 selected articles was performed.

Main Results:

  • Bromelain-based enzyme mixtures are currently used for burn eschar removal.
  • Enzymatic debridement selectively removes eschar in deep burns, potentially reducing skin grafting needs.
  • Off-label use of NexoBrid® for facial, pediatric, and large burns (>15% TBSA) is effective and safe.

Conclusions:

  • NexoBrid® facilitates selective eschar removal, often under regional anesthesia.
  • Optimal clinical wound bed evaluation post-NexoBrid® and treatment decisions require further study.
  • High-quality trials are needed to compare enzymatic debridement with standard care regarding effectiveness, surgical necessity, healing time, and scar quality.