{"id":"https://openalex.org/W7221635449","doi":"https://doi.org/10.3390/medsci14060667","title":"Systemic and Histopathological Effects of Bromelain-Based Enzymatic Debridement in Human Burns\u2014A Systematic Review","display_name":"Systemic and Histopathological Effects of Bromelain-Based Enzymatic Debridement in Human Burns\u2014A Systematic Review","publication_year":2026,"publication_date":"2026-10-13","ids":{"openalex":"https://openalex.org/W7221635449","doi":"https://doi.org/10.3390/medsci14060667","pmid":"https://pubmed.ncbi.nlm.nih.gov/42930587","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13707106"},"language":"en","primary_location":{"id":"doi:10.3390/medsci14060667","doi":"https://doi.org/10.3390/medsci14060667","is_oa":true,"landing_page_url":"https://doi.org/10.3390/medsci14060667","pdf_url":null,"source":{"id":"https://openalex.org/S2739445098","display_name":"Medical Sciences","issn_l":"2076-3271","issn":["2076-3271"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","medline","norway-1"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medical Sciences","raw_type":"journal-article"},"volume":null,"type":"review","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3390/medsci14060667","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5158648719","display_name":"Andrei-Nicolae Gologan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I304011483","display_name":"Grigore T. Popa University of Medicine and Pharmacy","ror":"https://ror.org/03hd30t45","country_code":"RO","type":"education","lineage":["https://openalex.org/I304011483"]},{"id":"https://openalex.org/I4210125798","display_name":"Spitalul Clinic Jude\u0163ean de Urgen\u0163e \"Sf. Spiridon\" Ia\u015fi","ror":"https://ror.org/03eyfxj96","country_code":"RO","type":"healthcare","lineage":["https://openalex.org/I4210125798"]}],"countries":["RO"],"is_corresponding":false,"raw_author_name":"Andrei-Nicolae Gologan","raw_affiliation_strings":["Department of Plastic Surgery and Reconstructive Microsurgery, Sf. Spiridon Emergency County Hospital, 700111 Iasi, Romania","Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Plastic Surgery and Reconstructive Microsurgery, Sf. Spiridon Emergency County Hospital, 700111 Iasi, Romania","institution_ids":["https://openalex.org/I4210125798"]},{"raw_affiliation_string":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania","institution_ids":["https://openalex.org/I304011483"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5112858629","display_name":"M Constantinescu","orcid":"https://orcid.org/0009-0000-8538-7811","observed_orcids":["https://orcid.org/0009-0000-8538-7811"]},"institutions":[{"id":"https://openalex.org/I304011483","display_name":"Grigore T. Popa University of Medicine and Pharmacy","ror":"https://ror.org/03hd30t45","country_code":"RO","type":"education","lineage":["https://openalex.org/I304011483"]},{"id":"https://openalex.org/I4210125798","display_name":"Spitalul Clinic Jude\u0163ean de Urgen\u0163e \"Sf. Spiridon\" Ia\u015fi","ror":"https://ror.org/03eyfxj96","country_code":"RO","type":"healthcare","lineage":["https://openalex.org/I4210125798"]}],"countries":["RO"],"is_corresponding":false,"raw_author_name":"Mihai-Codrin Constantinescu","raw_affiliation_strings":["Department of Plastic Surgery and Reconstructive Microsurgery, Sf. Spiridon Emergency County Hospital, 700111 Iasi, Romania","Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"],"raw_orcid":"https://orcid.org/0009-0000-8538-7811","affiliations":[{"raw_affiliation_string":"Department of Plastic Surgery and Reconstructive Microsurgery, Sf. Spiridon Emergency County Hospital, 700111 Iasi, Romania","institution_ids":["https://openalex.org/I4210125798"]},{"raw_affiliation_string":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania","institution_ids":["https://openalex.org/I304011483"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5007905347","display_name":"Dan-Cristian Moraru","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I304011483","display_name":"Grigore T. Popa University of Medicine and Pharmacy","ror":"https://ror.org/03hd30t45","country_code":"RO","type":"education","lineage":["https://openalex.org/I304011483"]},{"id":"https://openalex.org/I4210125798","display_name":"Spitalul Clinic Jude\u0163ean de Urgen\u0163e \"Sf. Spiridon\" Ia\u015fi","ror":"https://ror.org/03eyfxj96","country_code":"RO","type":"healthcare","lineage":["https://openalex.org/I4210125798"]}],"countries":["RO"],"is_corresponding":true,"raw_author_name":"Dan-Cristian Moraru","raw_affiliation_strings":["Department of Plastic Surgery and Reconstructive Microsurgery, Sf. Spiridon Emergency County Hospital, 700111 Iasi, Romania","Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Plastic Surgery and Reconstructive Microsurgery, Sf. Spiridon Emergency County Hospital, 700111 Iasi, Romania","institution_ids":["https://openalex.org/I4210125798"]},{"raw_affiliation_string":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania","institution_ids":["https://openalex.org/I304011483"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5066974324","display_name":"Stefana Avadanei-Luca","orcid":"https://orcid.org/0000-0002-9192-7607","observed_orcids":["https://orcid.org/0000-0002-9192-7607"]},"institutions":[{"id":"https://openalex.org/I304011483","display_name":"Grigore T. Popa University of Medicine and Pharmacy","ror":"https://ror.org/03hd30t45","country_code":"RO","type":"education","lineage":["https://openalex.org/I304011483"]},{"id":"https://openalex.org/I4210125798","display_name":"Spitalul Clinic Jude\u0163ean de Urgen\u0163e \"Sf. Spiridon\" Ia\u015fi","ror":"https://ror.org/03eyfxj96","country_code":"RO","type":"healthcare","lineage":["https://openalex.org/I4210125798"]}],"countries":["RO"],"is_corresponding":false,"raw_author_name":"Stefana Avadanei-Luca","raw_affiliation_strings":["Department of Plastic Surgery and Reconstructive Microsurgery, Sf. Spiridon Emergency County Hospital, 700111 Iasi, Romania","Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"],"raw_orcid":"https://orcid.org/0000-0002-9192-7607","affiliations":[{"raw_affiliation_string":"Department of Plastic Surgery and Reconstructive Microsurgery, Sf. Spiridon Emergency County Hospital, 700111 Iasi, Romania","institution_ids":["https://openalex.org/I4210125798"]},{"raw_affiliation_string":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania","institution_ids":["https://openalex.org/I304011483"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5117449726","display_name":"Alexandru-Hristo Amarandei","orcid":"https://orcid.org/0009-0000-2154-9236","observed_orcids":["https://orcid.org/0009-0000-2154-9236"]},"institutions":[{"id":"https://openalex.org/I304011483","display_name":"Grigore T. Popa University of Medicine and Pharmacy","ror":"https://ror.org/03hd30t45","country_code":"RO","type":"education","lineage":["https://openalex.org/I304011483"]},{"id":"https://openalex.org/I4210125798","display_name":"Spitalul Clinic Jude\u0163ean de Urgen\u0163e \"Sf. Spiridon\" Ia\u015fi","ror":"https://ror.org/03eyfxj96","country_code":"RO","type":"healthcare","lineage":["https://openalex.org/I4210125798"]}],"countries":["RO"],"is_corresponding":false,"raw_author_name":"Alexandru-Hristo Amarandei","raw_affiliation_strings":["Department of Plastic Surgery and Reconstructive Microsurgery, Sf. Spiridon Emergency County Hospital, 700111 Iasi, Romania","Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"],"raw_orcid":"https://orcid.org/0009-0000-2154-9236","affiliations":[{"raw_affiliation_string":"Department of Plastic Surgery and Reconstructive Microsurgery, Sf. Spiridon Emergency County Hospital, 700111 Iasi, Romania","institution_ids":["https://openalex.org/I4210125798"]},{"raw_affiliation_string":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania","institution_ids":["https://openalex.org/I304011483"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5158672509","display_name":"Dimitrie-Stefan Gologan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I304011483","display_name":"Grigore T. Popa University of Medicine and Pharmacy","ror":"https://ror.org/03hd30t45","country_code":"RO","type":"education","lineage":["https://openalex.org/I304011483"]}],"countries":["RO"],"is_corresponding":false,"raw_author_name":"Dimitrie-Stefan Gologan","raw_affiliation_strings":["Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania","institution_ids":["https://openalex.org/I304011483"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5158611092","display_name":"Bianca-Beatrice Carausu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I304011483","display_name":"Grigore T. Popa University of Medicine and Pharmacy","ror":"https://ror.org/03hd30t45","country_code":"RO","type":"education","lineage":["https://openalex.org/I304011483"]},{"id":"https://openalex.org/I4210125798","display_name":"Spitalul Clinic Jude\u0163ean de Urgen\u0163e \"Sf. Spiridon\" Ia\u015fi","ror":"https://ror.org/03eyfxj96","country_code":"RO","type":"healthcare","lineage":["https://openalex.org/I4210125798"]}],"countries":["RO"],"is_corresponding":false,"raw_author_name":"Bianca-Beatrice Carausu","raw_affiliation_strings":["Department of Dermatology, Sf. Spiridon Emergency County Hospital, 700111 Iasi, Romania","Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Dermatology, Sf. Spiridon Emergency County Hospital, 700111 Iasi, Romania","institution_ids":["https://openalex.org/I4210125798"]},{"raw_affiliation_string":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania","institution_ids":["https://openalex.org/I304011483"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5103199327","display_name":"Delia Gabriela Apostol Ciobanu","orcid":"https://orcid.org/0000-0003-4761-4133","observed_orcids":["https://orcid.org/0000-0003-4761-4133"]},"institutions":[{"id":"https://openalex.org/I304011483","display_name":"Grigore T. Popa University of Medicine and Pharmacy","ror":"https://ror.org/03hd30t45","country_code":"RO","type":"education","lineage":["https://openalex.org/I304011483"]}],"countries":["RO"],"is_corresponding":false,"raw_author_name":"Delia-Gabriela Ciobanu-Apostol","raw_affiliation_strings":["Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"],"raw_orcid":"https://orcid.org/0000-0003-4761-4133","affiliations":[{"raw_affiliation_string":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania","institution_ids":["https://openalex.org/I304011483"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5068779148","display_name":"Mihaela Per\u021bea","orcid":"https://orcid.org/0000-0002-5308-7192","observed_orcids":["https://orcid.org/0000-0002-5308-7192"]},"institutions":[{"id":"https://openalex.org/I304011483","display_name":"Grigore T. Popa University of Medicine and Pharmacy","ror":"https://ror.org/03hd30t45","country_code":"RO","type":"education","lineage":["https://openalex.org/I304011483"]},{"id":"https://openalex.org/I4210125798","display_name":"Spitalul Clinic Jude\u0163ean de Urgen\u0163e \"Sf. Spiridon\" Ia\u015fi","ror":"https://ror.org/03eyfxj96","country_code":"RO","type":"healthcare","lineage":["https://openalex.org/I4210125798"]}],"countries":["RO"],"is_corresponding":false,"raw_author_name":"Mihaela Pertea","raw_affiliation_strings":["Department of Plastic Surgery and Reconstructive Microsurgery, Sf. Spiridon Emergency County Hospital, 700111 Iasi, Romania","Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania"],"raw_orcid":"https://orcid.org/0000-0002-5308-7192","affiliations":[{"raw_affiliation_string":"Department of Plastic Surgery and Reconstructive Microsurgery, Sf. Spiridon Emergency County Hospital, 700111 Iasi, Romania","institution_ids":["https://openalex.org/I4210125798"]},{"raw_affiliation_string":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ia\u0219i, Romania","institution_ids":["https://openalex.org/I304011483"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5007905347"],"corresponding_institution_ids":["https://openalex.org/I304011483","https://openalex.org/I4210125798"],"apc_list":{"value":1400,"currency":"CHF","value_usd":1689},"apc_paid":{"value":1400,"currency":"CHF","value_usd":1689},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.63093836,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"14","issue":"6","first_page":"667","last_page":"667"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11422","display_name":"Burn Injury Management and Outcomes","score":0.9653000235557556,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11422","display_name":"Burn Injury Management and Outcomes","score":0.9653000235557556,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13725","display_name":"Pineapple and bromelain studies","score":0.03139999881386757,"subfield":{"id":"https://openalex.org/subfields/1312","display_name":"Molecular Biology"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10771","display_name":"Wound Healing and Treatments","score":0.0008999999845400453,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/bromelain","display_name":"bromelain","score":0.9169999957084656},{"id":"https://openalex.org/keywords/enzymatic-debridement","display_name":"enzymatic debridement","score":0.9860000014305115},{"id":"https://openalex.org/keywords/nexobrid","display_name":"Nexobrid","score":0.9860000014305115},{"id":"https://openalex.org/keywords/burn-debridement","display_name":"burn wound debridement","score":0.597000002861023},{"id":"https://openalex.org/keywords/partial-thickness-burns","display_name":"second-degree burns","score":0.8579999804496765},{"id":"https://openalex.org/keywords/systemic-inflammatory-response","display_name":"systemic inflammatory response","score":0.8640000224113464},{"id":"https://openalex.org/keywords/c-reactive-protein","display_name":"C-reactive protein","score":0.9919999837875366},{"id":"https://openalex.org/keywords/procalcitonin","display_name":"procalcitonin","score":1.0},{"id":"https://openalex.org/keywords/wound-infection","display_name":"wound infection","score":0.703000009059906},{"id":"https://openalex.org/keywords/fever","display_name":"fever","score":0.6200000047683716},{"id":"https://openalex.org/keywords/histopathology","display_name":"histopathology","score":0.7689999938011169},{"id":"https://openalex.org/keywords/tissue-preservation","display_name":"tissue preservation","score":0.43299999833106995}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9736999869346619},{"id":"https://openalex.org/C2777438270","wikidata":"https://www.wikidata.org/wiki/Q5248564","display_name":"Debridement (dental)","level":2,"score":0.7746000289916992},{"id":"https://openalex.org/C10936531","wikidata":"https://www.wikidata.org/wiki/Q786600","display_name":"Procalcitonin","level":3,"score":0.5640000104904175},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.5221999883651733},{"id":"https://openalex.org/C2993831823","wikidata":"https://www.wikidata.org/wiki/Q11068","display_name":"Blood stream","level":2,"score":0.5185999870300293},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.49959999322891235},{"id":"https://openalex.org/C95190672","wikidata":"https://www.wikidata.org/wiki/Q815382","display_name":"Meta-analysis","level":2,"score":0.4433000087738037},{"id":"https://openalex.org/C61470247","wikidata":"https://www.wikidata.org/wiki/Q7229825","display_name":"Population study","level":3,"score":0.41440001130104065},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.38760000467300415},{"id":"https://openalex.org/C2987804222","wikidata":"https://www.wikidata.org/wiki/Q5376582","display_name":"End point","level":2,"score":0.384799987077713},{"id":"https://openalex.org/C2780269544","wikidata":"https://www.wikidata.org/wiki/Q1509074","display_name":"Wound healing","level":2,"score":0.3675999939441681},{"id":"https://openalex.org/C3018263421","wikidata":"https://www.wikidata.org/wiki/Q80083","display_name":"Human studies","level":2,"score":0.3343999981880188},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.32749998569488525},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.31790000200271606},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.3075000047683716},{"id":"https://openalex.org/C63363279","wikidata":"https://www.wikidata.org/wiki/Q5133848","display_name":"Clinical significance","level":2,"score":0.3005000054836273},{"id":"https://openalex.org/C172268261","wikidata":"https://www.wikidata.org/wiki/Q4764988","display_name":"Animal studies","level":2,"score":0.2912999987602234},{"id":"https://openalex.org/C21613296","wikidata":"https://www.wikidata.org/wiki/Q4925405","display_name":"Coagulative necrosis","level":2,"score":0.26980000734329224},{"id":"https://openalex.org/C544855455","wikidata":"https://www.wikidata.org/wiki/Q1070952","display_name":"Histopathology","level":2,"score":0.26919999718666077},{"id":"https://openalex.org/C2777501473","wikidata":"https://www.wikidata.org/wiki/Q1796666","display_name":"Body surface area","level":2,"score":0.26899999380111694},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.26489999890327454},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.2517000138759613}],"mesh":[{"descriptor_ui":"D001963","descriptor_name":"Bromelains","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":true},{"descriptor_ui":"D002056","descriptor_name":"Burns","qualifier_ui":"Q000473","qualifier_name":"pathology","is_major_topic":true},{"descriptor_ui":"D002056","descriptor_name":"Burns","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D003646","descriptor_name":"Debridement","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016896","descriptor_name":"Treatment Outcome","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":4,"locations":[{"id":"doi:10.3390/medsci14060667","doi":"https://doi.org/10.3390/medsci14060667","is_oa":true,"landing_page_url":"https://doi.org/10.3390/medsci14060667","pdf_url":null,"source":{"id":"https://openalex.org/S2739445098","display_name":"Medical Sciences","issn_l":"2076-3271","issn":["2076-3271"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","medline","norway-1"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medical Sciences","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13707106","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13707106/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13707106/pdf/medsci-14-00667.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Med Sci (Basel)","raw_type":"Text"},{"id":"pmid:42930587","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42930587","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medical sciences (Basel, Switzerland)","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:ea50167ba0374873897f616527aac122","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/ea50167ba0374873897f616527aac122","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Medical Sciences, Vol 14, Iss 6, p 667 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3390/medsci14060667","doi":"https://doi.org/10.3390/medsci14060667","is_oa":true,"landing_page_url":"https://doi.org/10.3390/medsci14060667","pdf_url":null,"source":{"id":"https://openalex.org/S2739445098","display_name":"Medical Sciences","issn_l":"2076-3271","issn":["2076-3271"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","medline","norway-1"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medical Sciences","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Systematic Review","id":"https://openalex.org/study-designs/systematic-review"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7221635449.pdf","grobid_xml":"https://content.openalex.org/works/W7221635449.grobid-xml"},"referenced_works_count":36,"referenced_works":["https://openalex.org/W2004373870","https://openalex.org/W2043298850","https://openalex.org/W2047506534","https://openalex.org/W2081592593","https://openalex.org/W2089176039","https://openalex.org/W2132498904","https://openalex.org/W2163350549","https://openalex.org/W2320390425","https://openalex.org/W2329457372","https://openalex.org/W2531269403","https://openalex.org/W2763762093","https://openalex.org/W2794851314","https://openalex.org/W2990648940","https://openalex.org/W3014037023","https://openalex.org/W3036569374","https://openalex.org/W3096980309","https://openalex.org/W3118615836","https://openalex.org/W3196406139","https://openalex.org/W4200395065","https://openalex.org/W4205446252","https://openalex.org/W4211234775","https://openalex.org/W4294652725","https://openalex.org/W4311148403","https://openalex.org/W4367154057","https://openalex.org/W4383558828","https://openalex.org/W4384492973","https://openalex.org/W4386799114","https://openalex.org/W4389612630","https://openalex.org/W4390575368","https://openalex.org/W4399914187","https://openalex.org/W4409577061","https://openalex.org/W4412637492","https://openalex.org/W4412915285","https://openalex.org/W4417166354","https://openalex.org/W6921910732","https://openalex.org/W7140123465"],"related_works":["https://openalex.org/W7140123465","https://openalex.org/W4384492973","https://openalex.org/W7170056724","https://openalex.org/W3007350405","https://openalex.org/W3196142431","https://openalex.org/W6982195036","https://openalex.org/W2790089546","https://openalex.org/W3196406139","https://openalex.org/W4402433492","https://openalex.org/W4415730952"],"abstract_inverted_index":{"Background/Objectives:":[0],"Bromelain-based":[1],"enzymatic":[2,191],"debridement":[3,195,271],"(NexoBrid\u00ae)":[4],"is":[5,20,272],"an":[6],"established":[7],"tissue-preserving":[8],"alternative":[9],"to":[10,46,55],"tangential":[11],"excision":[12],"in":[13,38,67,96,124,159,166,201,238,305],"deep":[14],"partial-thickness":[15],"burns.":[16],"Its":[17],"clinical":[18,102,111],"efficacy":[19],"supported":[21],"by":[22,174],"randomised":[23],"trials,":[24],"but":[25],"its":[26,33],"systemic":[27,106,277],"effects":[28,34],"are":[29,40,282],"inconsistently":[30],"described":[31],"and":[32,54,74,80,90,93,136,140,148,164,185,242,263,308],"at":[35,300,309],"tissue":[36,286],"level":[37],"humans":[39],"largely":[41],"unknown.":[42],"The":[43,292],"objective":[44],"was":[45,132,143],"synthesise":[47],"the":[48,68,125,137,141,175,179,197,202,207,214,223,297,318],"human":[49,121,319],"evidence":[50],"on":[51],"both":[52],"domains":[53],"determine,":[56],"as":[57,210],"a":[58,211,217,255,257,260,275],"prespecified":[59],"endpoint,":[60],"whether":[61],"any":[62,266],"study":[63,172,204],"has":[64,288],"evaluated":[65],"them":[66],"same":[69,298],"patients.":[70],"Methods:":[71],"PubMed,":[72],"Embase":[73],"Scopus":[75],"were":[76,119,156,187,250],"searched":[77],"between":[78],"2016":[79],"2026":[81],"using":[82],"two":[83,165,293,301],"stream-specific":[84],"strategies":[85],"that":[86,205,287],"shared":[87],"their":[88,97],"intervention":[89],"population":[91],"blocks":[92],"differed":[94],"only":[95],"outcome":[98],"block:":[99],"Stream":[100,109,160,167],"A,":[101],"outcomes":[103,112],"reported":[104,113,254,265],"with":[105,114,134,222,274],"biological":[107],"parameters;":[108],"B,":[110],"histopathological":[115],"findings.":[116],"Eligible":[117],"studies":[118,155,249],"original":[120],"investigations":[122],"published":[123],"last":[126],"ten":[127,158],"years.":[128],"Risk":[129],"of":[130,181,216,232,240,303],"bias":[131],"assessed":[133],"ROBINS-I":[135],"JBI":[138],"checklists,":[139],"synthesis":[142],"narrative,":[144],"following":[145],"PRISMA":[146],"2020":[147],"SWiM.":[149],"Results:":[150],"Of":[151],"559":[152],"records,":[153],"twelve":[154],"included:":[157],"A":[161],"(970":[162],"patients)":[163],"B":[168],"(nine":[169],"patients);":[170],"no":[171],"identified":[173],"present":[176],"search":[177],"met":[178],"criteria":[180],"both.":[182],"C-reactive":[183],"protein":[184],"procalcitonin":[186],"significantly":[188],"higher":[189],"after":[190,193,322],"than":[192],"surgical":[194],"throughout":[196],"first":[198],"week,":[199],"and,":[200],"single":[203],"analysed":[206],"treated":[208,225],"area":[209,224],"continuous":[212],"exposure,":[213],"probability":[215],"post-debridement":[218],"coagulation":[219],"alteration":[220],"rose":[221],"(odds":[226],"ratio":[227],"1.158":[228],"per":[229],"percentage":[230,258],"point":[231],"body":[233],"surface).":[234],"Early":[235],"fever":[236],"occurred":[237],"14%":[239],"patients":[241,307],"predicted":[243],"later":[244],"wound":[245],"infection.":[246],"Both":[247],"histological":[248],"purely":[251],"qualitative:":[252],"neither":[253,264],"thickness,":[256],"or":[259],"cell":[261],"count,":[262],"laboratory":[267],"value.":[268],"Conclusions:":[269],"Enzymatic":[270],"associated":[273],"measurable":[276],"response":[278],"whose":[279],"proposed":[280],"mechanisms":[281],"all":[283],"statements":[284],"about":[285],"never":[289],"been":[290],"examined.":[291],"literature":[294],"fields":[295],"describe":[296],"process":[299],"levels":[302],"observation,":[304],"different":[306],"incompatible":[310],"times.":[311],"No":[312],"validated":[313],"instrument":[314],"exists":[315],"for":[316],"quantifying":[317],"burn":[320],"biopsy":[321],"debridement.":[323]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-10-14T00:00:00"}
