A new bromelain-based enzyme for the release of Dupuytren’s contracture

Rubin, Guy; Rinott, Micha; Wolovelsky, Alejandro; Rosenberg, Lior; Shoham, Yaron; Rozen, Nimrod

doi:10.1302/2046-3758.55.bjr-2016-0072

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…This might be due to less tissue trauma and time taken for removal of mesioangular, position A, and class I types of impactions in later types. [ 8 9 17 18 19 ]…”

Section: Discussionmentioning

confidence: 99%

Effect of proteolytic enzyme bromelain on pain and swelling after removal of third molars

Singh¹,

Fatima³

et al. 2016

J Int Soc Prevent Communit Dent

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Aims and Objectives:To evaluate the effect of bromelain on pain and swelling after surgical removal of third molars.Materials and Methods:A prospective randomized clinical study was conducted among 40 patients requiring surgical removal of impacted mandibular third molars. All the impacted molars were surgically removed, and the patients were administered bromelain along with amoxicillin. Patients were recalled on day 1, day 3, and day 7 for postoperative pain assessment using visual analogue scale (VAS) and postoperative swelling assessment using facial reference points tragus and pogonion. VAS score was statistically analyzed using repeated analysis of variance with post-hoc Bonferroni test postoperatively on day 1, day 3, and day 7 using the Statistical Package for the Social Sciences software version 14.Results:Out of the total 40 patients, bromelain was effective in 28 (70%) patients. In these patients, there was reduction in swelling and pain after taking bromelain.Conclusion:Bromelain can be used as a successful oral enzyme therapy for oral surgery patients, especially after removal of impacted third molars.

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“…This might be due to less tissue trauma and time taken for removal of mesioangular, position A, and class I types of impactions in later types. [ 8 9 17 18 19 ]…”

Section: Discussionmentioning

confidence: 99%

Effect of proteolytic enzyme bromelain on pain and swelling after removal of third molars

Singh¹,

Fatima³

et al. 2016

J Int Soc Prevent Communit Dent

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“…A PubMed search was performed, and four articles related to NexoBrid use were retrieved. 6 , [8][9][10] We excluded one article 9 because it focused on the use of a bromelain derivate for enzymatic fasciotomy in Dupuytren's disease. Among the remaining three articles, the most recent one reported the clinical case of a 14-year-old patient satisfactorily treated with NexoBrid after sustaining a burn injury due to explosion of the lithium battery in his mobile phone.…”

Section: Literature Review Of Bromelain Usementioning

confidence: 99%

Coagulation Abnormalities Following NexoBrid Use: A Case Report

Martín¹,

Guilabert²,

Abarca³

et al. 2017

Journal of Burn Care &Amp; Research

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Patients with major burn injury undergo a series of pathophysiologic changes that begin with a systemic inflammatory response and coagulation abnormalities, similar to those experienced by patients with sepsis or severe trauma. Coagulation changes in patients with burns are generally characterized by procoagulant abnormalities, but alterations in fibrinolysis and anticoagulation factors have also been observed. Around 40% of patients with major burn show changes on standard coagulation tests, and these have been related to the severity of the lesions, smoke inhalation, and administration of intensive fluid resuscitation therapy. Current surgical techniques for debridement of burn lesions are aggressive and associated with considerable blood loss. A fast-acting selective enzymatic debriding agent based on bromelain has been recently developed. NexoBrid is indicated for removing eschar in adults with deep partial- and full-thickness thermal burns. A potential effect of oral bromelain on hemostasis has been described, but it is uncertain whether NexoBrid application has a clinically relevant impact in this regard. We present the clinical case of a patient with burns who showed a coagulation abnormality shortly after NexoBrid use.

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“…Enzymatic debridement is an effective technique for selectively dissolving burn eschar and preserving as much healthy tissue and native dermis as possible, as has been reported in previous studies [6,8,14,42,43]. Several studies have been conducted to evaluate the efficacy and safety of enzymatic debridement in the treatment of hand burns [5,[44][45][46][47][48][49][50].…”

Section: Discussionmentioning

confidence: 99%

Assessing the Effect of Enzymatic Debridement on the Scar Quality in Partial-Thickness Burns to Deep Dermal Burns of the Hand: A Long-Term Evaluation

Heitzmann,

Schulz,

Fuchs

et al. 2024

Medicina

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Background and Objectives: Burn surgery on the hands is a difficult procedure due to the complex anatomy and fragility of the area. Enzymatic debridement has been shown to effectively remove burn eschar while minimizing damage to the surrounding tissue and has therefore become a standard procedure in many burn centers worldwide over the past decade. However, surprisingly, our recent literature review showed limited valid data on the long-term scarring after the enzymatic debridement of the hands. Therefore, we decided to present our study on this topic to fill this gap. Materials and Methods: This study analyzed partial-thickness to deep dermal burns on the hands that had undergone enzymatic debridement at least 12 months prior. Objective measures, like flexibility, trans-epidermal water loss, erythema, pigmentation, and microcirculation, were recorded and compared intraindividually to the uninjured skin in the same area of the other hand to assess the regenerative potential of the skin after EDNX. The subjective scar quality was evaluated using the patient and observer scar assessment scale (POSAS), the Vancouver Scar Scale (VSS), and the “Disabilities of the Arm, Shoulder, and Hand” (DASH) questionnaire and compared interindividually to a control group of 15 patients who had received traditional surgical debridement for hand burns of the same depth. Results: Between January 2014 and December 2015, 31 hand burns in 28 male and 3 female patients were treated with enzymatic debridement. After 12 months, the treated wounds showed no significant differences compared to the untreated skin in terms of flexibility, trans-epidermal water loss, pigmentation, and skin surface. However, the treated wounds still exhibited significantly increased blood circulation and erythema compared to the untreated areas. In comparison to the control group who received traditional surgical debridement, scarring was rated as significantly superior. Conclusions: In summary, it can be concluded that the objective skin quality following enzymatic debridement is comparable to that of healthy skin after 12 months and subjectively fares better than that after tangential excision. This confirms the superiority of enzymatic debridement in the treatment of deep dermal burns of the hand and solidifies its position as the gold standard.

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A new bromelain-based enzyme for the release of Dupuytren’s contracture

Cited by 5 publications

References 23 publications

Effect of proteolytic enzyme bromelain on pain and swelling after removal of third molars

Effect of proteolytic enzyme bromelain on pain and swelling after removal of third molars

Coagulation Abnormalities Following NexoBrid Use: A Case Report

Assessing the Effect of Enzymatic Debridement on the Scar Quality in Partial-Thickness Burns to Deep Dermal Burns of the Hand: A Long-Term Evaluation

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