Abstract
NexoBrid® is a relatively new agent that was approved in Japan in 2022 and launched commercially in 2023; therefore, clinical experience remains limited. In 2024, we experienced three cases of deep dermal burns (DDB)or deep burns (DB) (one flame burn, one contact burn, and one scald burn) who received treatment with NexoBrid® at our institution. In all cases, residual burn eschar was present, requiring surgical debridement. We analyzed the contributing factors and classified them into three categories: case, surgeon, and method of use. The results showed that multiple factors were involved, including the amount of burn eschar and dermis thickness, concomitant infection, prior use of silver-containing wound dressing material, earliness of application in the scald burn case, and physical barrier instability due to the use of Vaseline. These are pitfalls that are likely to occur in the early stages of NexoBrid® introduction. We report our experience, with a discussion of countermeasures, indication assessment, and technical refinements.
