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Enzymatic debridement of deep facial burns with Nexobrid™: the Queen Victoria Hospital experience

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Abstract

Background

Deep facial burns present unique challenges due to the risk of scarring and contracture which can negatively impact patients’ cosmesis and function. Enzymatic debridement of burns with bromelain-based agents, such as Nexobrid™, may improve scarring through maximal preservation of viable tissue. However, Nexobrid™ use in facial burns is poorly described in the literature.

Methods

We conducted a single-centre case series, retrospectively reviewing all patients treated with Nexobrid™ for deep facial burns between January 2016 and July 2022.

Results

We identified five female patients aged 27–69 with 1–6% deep burns of different aetiologies (flame, contact and flash flame). All patients received Nexobrid™ within 72 hours of injury and underwent allograft application the following day. Length of hospital stay ranged from 3 to 10 days (mean 4.6). Four out of five patients underwent delayed autograft at 15 to 29 days (mean 25), and the time to complete healing varied from 24 to 93 days (mean 52). Patients displayed good aesthetic and functional outcomes at follow-up ranging from 3 to 36 months.

Conclusions

From our experience at Queen Victoria Hospital, we observed good aesthetic and functional outcomes using Nexobrid™ in deep facial burns. The process is safe and effective, and we hope that our contribution will encourage further research and practice in this field.

Level of evidence

Level IV, Therapeutic.

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Author information

Author notes

  1. Alexandra MacKenzie and Maria Chicco contributed equally to this work.

Authors and Affiliations

  1. Imperial College School of Medicine, Imperial College London, London, UK

    Alexandra MacKenzie

  2. Department of Plastic and Reconstructive Surgery, Queen Victoria Hospital, Holtye Road, East Grinstead, RH19 3DZ, UK

    Maria Chicco & Baljit Dheansa

Authors
  1. Alexandra MacKenzie
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  2. Maria Chicco
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  3. Baljit Dheansa
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Corresponding author

Correspondence to Maria Chicco.

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Funding

The authors declare that no funds, grants or other support were received during preparation of this manuscript.

Ethics approval

The study protocol was registered as ‘Service Evaluation’ with the local research and audit department. Therefore, ethical approval was not required, in line with UK Health Research Authority guidelines.

Consent for publication

The authors confirm that patients provided constent for sharing their data. Additional informed patient consent was obtained for publication of the images in Figs. 2, 3, 4, and 5.

Competing interests

Alexandra MacKenzie, Maria Chicco and Baljit Dheansa declare no competing interests.

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MacKenzie, A., Chicco, M. & Dheansa, B. Enzymatic debridement of deep facial burns with Nexobrid™: the Queen Victoria Hospital experience. Eur J Plast Surg 46, 1315–1322 (2023). https://doi.org/10.1007/s00238-023-02100-1

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  • DOI: https://doi.org/10.1007/s00238-023-02100-1

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