Bromelain-Based Enzymatic Debridement Versus Standard of Care in Deep Burn Injuries: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis evaluates the efficacy and safety of bromelain-based enzymatic debridement, specifically using NexoBrid, compared to standard of care (SOC) in treating partial and full thickness burn injuries. Analyzing seven studies with 484 patients, the review found that bromelain significantly reduced the time to eschar removal and lowered the incidence of surgical excision and autograft procedures, without adversely affecting wound closure time or long-term scar quality as measured by the Modified Vancouver Scar Scale. While the findings suggest bromelain enzymatic debridement as a less invasive and effective alternative to traditional surgical methods, the authors note limitations including study heterogeneity and the inclusion of both randomized and non-randomized trials, indicating a need for further research to optimize treatment protocols.