Burns. 2025 Nov 20;52(1):107803. doi: 10.1016/j.burns.2025.107803. Online ahead of print.

Recent advances in burn care have highlighted the benefits of enzymatic debridement in reducing long-term scarring by preserving viable dermal structures. Nexobrid®, a bromelain-based enzymatic debridement agent, has become an established treatment modality for deep-dermal burns, particularly of the hand, due to its selective action and tissue-sparing properties. After debridement, the choice of dressing critically influences inflammation, re-epithelialization, and ultimately scar quality and skin function. In clinical practice, Suprathel®, a synthetic copolymer membrane, and Jelonet®, a paraffin-impregnated gauze, are widely used. While Suprathel® offers improved pain control and patient comfort, Jelonet® remains a cost-effective standard. Building on our previous intra-individual trial, which showed similar healing times but greater patient comfort with Suprathel®, this planned single-center, prospective long-term follow-up aims to address the lack of data on long-term scar quality and skin barrier function after enzymatic debridement. It includes the same 23 patients with deep-dermal hand burns who had received wound coverage with both Suprathel® and Jelonet® on comparable wound areas, assessed at 3, 6, and 12 months using objective instruments (Cutometer®, Mexameter®, Tewameter®, O2C®) and subjective scales (Vancouver Scar Scale, Patient and Observer Scar Assessment Scale). Both dressings resulted in favorable and largely comparable scar outcomes over 12 months, with no significant differences in elasticity, perfusion, or overall clinical scar appearance. Subtle yet statistically significant differences in transepidermal water loss (p < 0.01) and pigmentation (p < 0.01) indicated a trend toward enhanced epidermal barrier restoration and reduced hypopigmentation in Suprathel®-treated areas, although these effects did not translate into perceptible clinical advantages. These results confirm that both Suprathel® and Jelonet® are effective options for post-enzymatic debridement wound coverage, showing comparable long-term scar outcomes. The choice may reasonably depend on clinical workflow and dressing-management preferences, with Suprathel® remaining the standard in our burn center due to its reduced frequency of dressing changes.

PubMed:41274105 | DOI:10.1016/j.burns.2025.107803