Bromelain-based enzymatic debridement versus standard of care in deep partial- and full-thickness burns: A systematic review and meta-analysis of randomized controlled trials.
Federico Sacasa, Gustavo Herdocia Baus, Myiah P Quach et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the effectiveness of bromelain-based enzymatic debridement (BBD) compared to standard of care (SOC) in patients with deep partial- and full-thickness burns. The analysis included five randomized trials with a total of 336 participants. BBD significantly reduced the need for surgical excision (RR, 0.11; 95% CI, 0.06-0.23), indicating a 65% absolute risk reduction.
Key findings
- BBD reduced the need for surgical excision compared to SOC (RR, 0.11; 95% CI, 0.06-0.23).
- The absolute risk reduction for surgical excision was 65%, with a number needed to treat of 1.5.
- BBD was associated with reduced autograft use and shorter time to debridement.
- Blinded scar assessments at 12 months were comparable or improved with BBD.
Why it matters
The findings suggest that bromelain-based enzymatic debridement may offer a more effective approach for managing deep thermal burns, potentially reducing the need for surgical interventions and improving patient outcomes. This could influence treatment protocols in burn care.
What to keep in mind
The open-label design of the included trials was a significant source of potential bias.