Dr Amelia Perri¹, Dr Carl Lisec¹, Elena Blyth¹ ,  Dr Jason Brown¹, Allison Hill¹, Amber Jones¹, Anita  Plaza¹, Dr Kate McCrossin¹, Andrea McKittrick¹ 

¹The Royal Brisbane And Women’s Hospital, Herston, Australia

Abstract:

Introduction: Early surgical debridement followed by autologous skin grafting is the standard of care (SOC) internationally for burn treatment as it prevents early complications and minimises hypertrophic scarring. A major disadvantage of the SOC is the tendency to remove excess tissue, including healthy dermis. This is a well-known phenomenon referred to as “the perfect crime” (Granick et al. 2007).  NexoBrid is a bromelain-based enzymatic debriding agent that is well established in many European burn centres. It is a lyophilised, partially purified, proteolytic protein mixture derived from Bromelain raw material extracted from pineapple stems (Rosenberg et al. 2014). Studies have shown that topically applied NexoBrid selectively removes the burn eschar after a single 4-hour application, leaving behind a clean and viable wound bed (Rosenberg et al. 2012, Singer et al. 2011, Singer et al. 2010(a), Singer et al. 2010(b), Rosenberg et al. 2004).

Methodology: In this pilot study, the effectiveness of NexoBrid will be assessed compared to the surgical SOC. Twenty patients with upper limb burns will be consecutively allocated into two groups of ten (NexoBrid or SOC). It is hypothesised that NexoBrid will reduce patient length of stay in hospital. Secondary outcomes include pain, patient experience, and early functionality of the upper limb.

Results: This study is in the active participant recruitment phase. We anticipate having enough data by September to present our findings. The authors strongly feel that this study would contribute to the current discussion of non-surgical burns management and the value of the multidisciplinary team. The logistics of integrating NexoBrid administration into a standard workday of burn surgeons, anaesthetists, nurses, physiotherapists and occupational therapists at a tertiary hospital will be emphasised.

Conclusion: TBD.

References: (please contact for full reference list)

1. Granick MS & Gamelli, RL 2007. Surgical Wound Healing and Management, CRC Press, Boca Raton, Florida.

Biography:

Dr. Carl Lisec is a Burn and General Surgeon at the Professor Stuart Pegg Adult Burn Centre and Jamieson Trauma Institute (Royal Brisbane and Women’s Hospital). He is a Senior Lecturer at the University of Queensland.

Dr. Amelia Perri is a junior doctor at the Royal Brisbane and Women’s Hospital.