This is an interesting study looking at the outcomes following enzymatic debridement of deep facial burns. The authors directly compare enzymatic debridement with NexoBrid® and traditional excisional debridement in deep facial burns. They specifically analyse the debridement efficacy, acute healing phase, and objective and subjective scar evaluation after 12 months. A prospective controlled clinical study was designed with 13 patients enrolled over a 12-month period and treated with NexoBrid®. These patients were then compared with the last 13 patients that were treated with surgical debridement on their database. The authors found that 77% of facial burns treated with Nexobrid® appeared more superficial after treatment than initially assessed, leading to the majority of these wounds healing without requirement for a skin graft. Overall 85% of all wounds in the Nexobrid® group healed spontaneously without grafting. Excellent long-term cosmetic results were found following various subjective and objective tests for scar assessment. The main limitation that is stated by the authors is the inability of blinding in the study. Regardless of this, the study should by widely read by the burns community, as these are important findings. The ease and quickness of use of Nexobrid® coupled with the excellent aesthetic long-term results and a lesser need for grafting reveals this as a very appealing option. 

Enzymatic debridement of deeply burned faces: healing and early scarring based on tissue preservation compared to traditional surgical debridement.
Schulz A, Fuchs PC, Rothermundt I, et al.

BURNS
2017;43(6):1233-43.
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Jill Baker

St John’s Hospital, Livingston, UK

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