Enzymatic Debridement for the Prevention of Burn Induced Compartment Syndrome: Utility or Futility?

Circumferential full-thickness burns present a significant risk for Burn-Induced Compartment Syndrome (BICS), often necessitating escharotomy to restore circulation. Traditional surgical approaches carry inherent risks, prompting the exploration of enzymatic debridement with NexoBrid® (EDNX) for swift and selective eschar removal. However, concerns persist regarding its efficacy in preventing BICS and its impact on elevated compartment pressures. This case series evaluates the use of early enzymatic debridement with NexoBrid® in patients with circumferential burns affecting the upper and lower extremities and the abdominal region. Our findings suggest that EDNX has the potential to serve as an alternative to traditional escharotomy by reducing the need for surgical intervention while maintaining vital functions. However, given the limited sample size, further controlled studies are necessary to confirm these preliminary observations.