Enzyme Extract Debrides Eschar from Severe Burns

A pineapple enzyme-based debriding agent adds new treatment option for removing eschar, the dried-out, thick, leathery, black necrotic tissue that covers severe burn wounds.

NexoBrid is a bromelain based enzymatic agent that provides an alternative to current eschar removal means, such as surgery. It is intended to remove the burn eschar after a 4-hour application, and is based on a mixture of proteolytic enzymes extracted from the pineapple plant stem. The drug is composed of a pack that includes a lyophilized sterile mixture of the proteolytic enzymes and a sterile medical hydrating gel. The mixture of both components is applied on the wound surface, and the dissolved eschar (in the form of a gelatinous mass) is wiped away, with no surgical or other special procedures, exposing the clean wound bed for physician visual assessment and treatment.

In second-degree burns, if a residual clean exposed dermis survives, it may epithelialize and heal spontaneously. Full thickness third degree burns, devoid of any healing sources (viable dermis and epithelium) will heal only if a living skin graft is harvested from healthy donor sites. NexoBrid is a product of MediWound (Yavne, Israel). Both the US Food and Drug Administration (FDA) and the European Medicines Agency Committee for Medicinal Products for Human Use (CHMP) have granted orphan drug status for NexoBrid, which grants the company exclusivity for 7 and 10 years, respectively, for debridement of deep partial or full thickness burns in hospitalized patients.

It is commonly accepted that thorough wound eschar removal should be performed as soon as possible post injury in order to prevent further deterioration and to preserve any viable tissue, facilitating spontaneous healing and minimizing the need for grafting.

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