Background: Burn injuries are a significant global health concern, leading to substantial morbidity and mortality. Scarring, a common complication of burns, can significantly impair function, appearance, and quality of life. While various therapeutic strategies exist, the search for effective and safe
scar management approaches continues. Bromelain, a proteolytic enzyme derived from pineapple stem, has shown promise in
wound healing and anti-inflammatory activities, sparking interest in its potential for
scar reduction. Methods: A comprehensive search of relevant databases (PubMed, Google Scholar, Cochrane and scopus) was conducted using keywords such as 'bromelain,' 'burn,' 'scar,' 'wound healing,' and 'skin regeneration' from ۲۰۰۰ up to October ۲۰۲۴. Result: Following a
burn injury, there is an increase in proteolytic activity at the site of the wound. Bromelain as a proteolytic enzyme, has been specifically utilized to debride
burn wounds and facilitates wound healing. It also preserves the integrity of the surrounding healthy tissue so the application of
bromelain for the debridement of eschar in deep burns is regarded effective and can reduce the autografting. NexoBrid a concentrate of proteolytic enzymes enriched in
bromelain is a product designed for topical application and can dissolve
burn eschar. Early debridement is considered a crucial component in the management of deep partial and full thickness burns. This procedure is intended to manage wound bioburden effectively and facilitate prompt wound closure. The preservation of viable dermis, along with early wound closure, is viewed as an essential measure to minimize complications associated with scarring. Early removal of eschar within ۷۲ hours enhances the results of
burn wound management by decreasing bacterial colonization, minimizing the risk of infection, and shortening the duration of hospitalization. NexoBrid achieves early complete eschar removal (ER) in over ۹۰% of
burn patients, while also decreasing the median time to ER, minimizing blood loss, reducing the area of burns excised, and lowering the necessity for surgical intervention. Oral Bromelain has shown the potential effect on alleviate pain following free gingival grafting and may additionally promote the healing of wounds but the significant pain levels reported with the NexoBrid™ procedure and subsequently its need for local anesthesia, have posed considerable obstacles to the integration of
