Breidung David, Billner Moritz, Ortner Felix, von Imhoff Philipp, Lapinskas Simonas, Karcz Konrad, Delavari Sarina, Ehrl Denis
Department of Plastic, Reconstructive and Hand Surgery, Burn Unit, Paracelsus Medical University, Klinikum Nürnberg, Breslauer Str. 201, 90471 Nuremberg, Germany.
J Pers Med. 2025 Jul 25;15(8):330. doi: 10.3390/jpm15080330.
Enzymatic debridement with NexoBrid is an effective alternative to surgical debridement in burn care, but its potential systemic effects remain unclear. In the context of personalized burn care, understanding individual patient responses to topical agents is essential to optimize outcomes and minimize risks. This study aimed to characterize laboratory and clinical parameter changes following NexoBrid application in patients with small burn injuries (≤10% TBSA). We retrospectively analyzed 75 burn patients treated with NexoBrid to evaluate changes in systemic inflammatory markers, coagulation parameters, and clinical parameters before and after enzymatic debridement. Statistically significant increases in body temperature ( = 0.018), decreases in hemoglobin ( < 0.001), and increases in C-reactive protein (CRP) levels ( < 0.001) were observed, suggesting mild systemic inflammatory changes. However, leukocyte counts did not change significantly ( = 0.927), and body temperature remained within the normothermic range, indicating that these changes were not clinically significant. A significant decrease in the prothrombin time ratio (% of normal; = 0.002) was also observed, suggesting potential impacts on coagulation. Importantly, while body temperature was slightly higher in patients with a higher degree of BSA exposure within the ≤10% TBSA cohort ( = 0.036), the extent of NexoBrid application did not correlate with other inflammatory markers. These findings suggest that measurable systemic changes can occur following NexoBrid application in small burns, particularly affecting inflammatory and coagulation parameters. These observations contribute to the understanding of treatment-related responses and may help inform clinical decision-making.
在烧伤护理中，使用NexoBrid进行酶促清创是手术清创的一种有效替代方法，但其潜在的全身影响仍不明确。在个性化烧伤护理的背景下，了解个体患者对局部用药的反应对于优化治疗效果和降低风险至关重要。本研究旨在描述小面积烧伤（≤10% 体表面积）患者应用NexoBrid后实验室和临床参数的变化。我们回顾性分析了75例接受NexoBrid治疗的烧伤患者，以评估酶促清创前后全身炎症标志物、凝血参数和临床参数的变化。观察到体温有统计学意义的升高（ = 0.018）、血红蛋白降低（ < 0.001）以及C反应蛋白（CRP）水平升高（ < 0.001），提示有轻度全身炎症变化。然而，白细胞计数无显著变化（ = 0.927），体温仍在正常体温范围内，表明这些变化无临床意义。还观察到凝血酶原时间比值（正常百分比； = 0.002）显著降低，提示对凝血有潜在影响。重要的是，在≤10% 体表面积队列中，烧伤面积百分比更高的患者体温略高（ = 0.036），但NexoBrid的应用范围与其他炎症标志物无关。这些发现表明，小面积烧伤患者应用NexoBrid后可出现可测量的全身变化，尤其影响炎症和凝血参数。这些观察结果有助于理解与治疗相关的反应，并可能有助于为临床决策提供参考。
