2025 Volume 51 Issue 1 Pages 15-20
NexoBrid® is an enzymatic debridement agent that was launched in August 2023. There are still few reports of its use in Japan. In the present study, we encountered a case with an unusual course. The patient was an 84-year-old woman who presented with second- to third-degree burns due to hot water from a bathtub. The total body surface area of the burns was about 52% on both lower legs and trunk. NexoBrid® was applied to the burns on both legs the day after the injury. A dark purple discoloration was observed at the application site. Histological examination revealed that most of the necrotic dermis remained intact; however, subcutaneous hemorrhage was observed. Two days after application, the wound surface remained unchanged.
On the third day, additional surgical debridement was performed, including other affected areas. In burns caused by fluids at lower wound temperatures, the absence of wound surface gelatinization may reduce the effectiveness of NexoBrid® and increase the risk of subcutaneous hemorrhage. If widespread subcutaneous hemorrhagic spots appear as a uniform red discoloration after application, necrosis may persist, and early debridement may be advisable.
