Dr Yaron Shoham¹

¹Soroka Medical Center, Beer Sheba, Israel

Abstract:

The search for a safe and effective enzymatic burn debrider has been ongoing since the middle of the 20th century. NexoBrid, an enzymatic burn debrider made from the stems of pineapples, was approved for use in the EU a decade ago, after more than 2 decades of preclinical and clinical trials. Since then NexoBrid has been approved in 50 countries worldwide, and is in advanced stages of approval in other territories. During the past decade nearly 10,000 patients suffering from deep burns were treated with NexoBrid worldwide. The introduction of NexoBrid into the treatment protocols of burn centers followed a pre-defined training program that included a basic medical training followed by ongoing telemedicine support and advanced trainings during the initial learning curve. Additionally, a total of 3 phase III RCTs (conducted on adults and children during the past decade) demonstrated its safety and efficacy, with a consistent incidence of complete debridement of at least 93%. More than 100 papers have been published on the subject including a European consensus paper and several national consensus papers. Lessons learned during the past decade since EU approval include the learning curve associated with assessment of the post NexoBrid wound bed and decision whether or not grafting is needed, decrease in the need for surgical excision and grafting and according indications, superior 12 months scarring results in adults, prolongation of the post NexoBrid antibacterial soaking from 2 to  ~24 hours, the role of advanced dressings and skin substitutes post NexoBrid, recommendation for delaying autografting for several days post NexoBrid, and off label treatment aspects such as treatment of children and systemic effects while treating major burns. These evidence based published advancements in NexoBrid treatment will be presented in detail.

Biography:

Dr. Shoham is the director of the burns unit at the Soroka Medical Center in Israel, and the current chairman of the Israeli Burns Association. Dr. Shoham has been involved in the NexoBrid enzymatic burn debridement program for >15 years, as an investigator and a medical director for MediWound Ltd.