Enzymatic debridement with NexoBrid

This is patient and carers information  designed to help patients and carers understand what NexoBrid is, how it works and what to expect.

Enzymatic debridement with NexoBrid

NexoBrid is an enzyme which targets and dissolves dead tissue called eschar, which is caused by a burn.

It is important to remove eschar so that the healing of your wound can start.

NexoBrid comes in two bottles. The first bottle contains the NexoBrid enzyme in powder form and the second bottle contains gel in which the powder dissolves. The health care professional will mix these two bottles prior to application.

NexoBrid application

The health care professional cleans your wound and applies a wet soak for two hours/or overnight. This is to ensure that the wound is clean, moist and ready for the NexoBrid application.

After the pre-soaking period the health care professional will remove the wet soak and assess the wound. The application of NexoBrid can begin. You will be given painkillers beforehand.

The application itself takes just a few minutes. The gel is applied to your burn and an occlusive dressing is put on top of the wound. Soft fluffy dressings are then applied on top of the occlusive dressings.

And then

Now it’s time for NexoBrid to work. This will take four hours. During this time, make yourself as comfortable as you can but try not to move the dressed area too much making sure the dressings stays in place. Report any discomfort so additional pain relief can be administered by the health care professionals.

After four hours it is time to remove the dressings and check the wound. At this stage the NexoBrid residue will be wiped off with the dissolved burn eschar. 

Once it’s all wiped off a new wet soak is applied to your wound for two hours. This is to make sure that the residue of NexoBrid and eschar is removed. Please be aware that your Doctor may require you to stay in overnight if additional wound soaking is required. 

After removal of the  wet soaks your Burns Consultant will review the clean debrided wound and will advise on the best treatment for you. This may be conservative dressing treatment or surgery may be necessary.

What is NexoBrid?

NexoBrid is made up of proteolytic enzymes which are a mixture of enzymes from the stem of the Ananas Comosus (pineapple plant).

How does it work?

The enzymes in NexoBrid work by targeting and dissolving dead tissue. It will not damage any healthy skin as the enzyme only targets dead tissue. 

Is it painful?

The Burns team will give you pain killers throughout the NexoBrid procedure. This may be in the form of intravenous opioid analgesia and sedation or through a patient-controlled analgesia system (PCA) which you can control the deliver of opioid analgesia. 

Additional pain relief options may be offered such as a regional block which will numb the affected area and can last up to 18 - 24 hours or oral analgesia. Additional pain relief is available and mild sedation depending on your individual pain needs. Your pain levels will be continually assessed and monitored during the NexoBrid process to ensure you are as comfortable as possible. If you experience any discomfort you will need to inform your nurse or doctor looking after you. 

Can I eat and drink while NexoBrid is working?

Your doctor will advise you about eating and drinking depending on what level of painkillers and/or sedation you have received.

Will NexoBrid damage my healthy skin?

No. The enzyme only targets dead tissue.

Further information about NexoBrid                                                                                                                

NexoBrid® - Mediwound 

© North Bristol NHS Trust. This edition published February 2024. Review due February 2027. NBT003118.