{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T20:16:16Z","timestamp":1789157776404,"version":"build-2803163510"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T00:00:00Z","timestamp":1585612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Burn-induced compartment syndrome represents a serious and acute condition in deep circumferential burns of the extremities which, if left untreated, can cause severe complications. The surgical escharotomy that releases the high subdermal pressure is the therapeutic treatment of choice for burn-induced compartment syndrome. Guidelines for escharotomy indications and timing include pressure greater than 30 mm Hg and 6 Ps (Pain, Pallor, Paresthesia, Paralysis, Pulseless, and Poikilothermia). Nevertheless, despite the need for an early as possible pressure release, escharotomy is often delayed when a capable surgeon is not available, or if the indication is not completely clear to justify potential risks associated with surgical escharotomy. Early treatment of circumferential burns of the extremities with a Bromelain-based enzymatic agent NexoBrid\u00ae may represent a less traumatic and invasive procedure to reduce intra-compartmental pressure, replacing surgical escharotomy. This case study of 23 patients describes the variation of compartmental pressure in patients with circumferential burns of the extremities treated with NexoBrid\u00ae enzymatic escharotomy-debridement. All the patients were treated with NexoBrid\u00ae within 2 to 22 hours post-injury in our Burn Intensive Care Center. The excessive pressure recorded before treatment returned to normal below 30 mm Hg and an approximately 60% reduction of the compartmental pressure was observed in most cases within 1 hour from NXB application. On NexoBrid\u00ae removal after 4 hours complete debridement-escharotomy of the burns was achieved. Enzymatic escharotomy-debridement appears to be a useful and safe method to reduce postburn compartmental pressure. Additional randomized, well-controlled powered studies are needed to further support these results.<\/jats:p>","DOI":"10.1093\/jbcr\/iraa055","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T04:55:10Z","timestamp":1585630510000},"page":"1097-1103","source":"Crossref","is-referenced-by-count":19,"title":["Releasing Burn-Induced Compartment Syndrome by Enzymatic Escharotomy-Debridement: A Case Study"],"prefix":"10.1093","volume":"41","author":[{"given":"Ilaria","family":"Mataro","sequence":"first","affiliation":[{"name":"Plastic and Reconstructive Surgery and Burn Unit, Hospital A. Cardarelli, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Lanza","sequence":"additional","affiliation":[{"name":"Burn Intensive Care Unit, Hospital A. Cardarelli, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sveva","family":"Di Franco","sequence":"additional","affiliation":[{"name":"Resident Doctor in Anesthesia, Critical Care and Pain Medicine, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8335-2268","authenticated-orcid":false,"given":"Livia","family":"Di Franco","sequence":"additional","affiliation":[{"name":"Resident Doctor in General Surgery, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariella","family":"Sangiuolo","sequence":"additional","affiliation":[{"name":"Burn Intensive Care Unit, Hospital A. Cardarelli, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Notaro","sequence":"additional","affiliation":[{"name":"Burn Intensive Care Unit, Hospital A. Cardarelli, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"d\u2019Alessio","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery and Burn Unit, Hospital A. Cardarelli, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romolo","family":"Villani","sequence":"additional","affiliation":[{"name":"Burn Intensive Care Unit, Hospital A. 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