Enzymatic Debridement with NexoBrid® for Low-Temperature Burns

Enzymatic debridement, particularly with Nexobrid®, has become a common method for selective removal of necrotic tissue in burn care.Nexobrid® acts through gelatinase activity and is typically applied within 72 h of injury following a 2-h eschar presoak.However, its efficacy in low-temperature burns is not well documented.We describe a case of third-degree low-temperature burns on a patient's back and right upper arm, where Nexobrid® was applied 12 days post-injury after a 2-hour pre-soaking.Necrotic tissue removal was incomplete, and additional surgical debridement was required.The relevant literature suggests that the poor efficacy may be due to limited collagen denaturation into gelatin in low-temperature burns or insufficient moisture penetration with a 2-h pre-soak.Low-temperature burns are often treated after delays, which may further reduce the effectiveness of the Nexobrid®.For such burns, early intervention or extended pre-soaking may improve patient outcomes.