The effect of fibrinolysin ointment in the treatment of burn scars: A narrative review article

Burn injuries are a significant global health concern, ranking among the most common causes of trauma and leading to severe physical, functional, and psychosocial consequences. Effective burn wound management aims not only to promote healing but also to minimize scarring, infection, and long-term complications. Fibrinolysin ointment, a topical enzymatic agent containing proteolytic enzymes such as fibrinolysin, deoxyribonuclease, and trypsin, has been investigated as a treatment option for improving burn wound outcomes. This narrative review explores the potential therapeutic benefits, mechanisms of action, clinical applications, and limitations of fibrinolysin ointment in the context of burn injuries. Fibrinolysin functions primarily through enzymatic debridement, dissolving necrotic tissue, facilitating wound cleansing, reducing bacterial colonization, and stimulating tissue regeneration. Its anti-inflammatory properties also help reduce edema and local pain, creating a favorable microenvironment for re-epithelialization and collagen remodeling. Several animal studies suggest its usefulness in promoting faster healing in second- and third-degree burns. However, the results are often less favorable when compared to more aggressive enzymatic agents or natural alternatives, such as kiwi extract or honey. While fibrinolysin has shown promise in reducing healing time and indirectly improving scar quality, there is a lack of robust human clinical trials assessing its long-term effects on scar formation, particularly through the use of standardized scar assessment scales. Although generally safe with minimal side effects, fibrinolysin ointment may cause localized irritation or hypersensitivity in some patients. This review concludes that while fibrinolysin may serve as a supportive treatment in burn care, especially in superficial wounds, further clinical research is warranted to validate its efficacy, optimize its usage, and establish its role in multidisciplinary burn scar management protocols.