{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:22:02Z","timestamp":1772778122678,"version":"3.50.1"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100031014","name":"Vericel Corporation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100031014","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Enzymatic debridement with anacaulase-bcdb was approved by the US Food and Drug Administration in 2023. The purpose of this study is to compare outcomes from our first cohort of patients treated with this novel enzymatic agent. We compared patients treated with anacaulase-bcdb at our burn center from November 2023 to August 2024 to a 1:1 matched control group. Demographic, clinical, and photographic data were collected to ensure appropriate matching. Outcomes included: hospital length of stay, number of surgeries, time to first surgery, autograft size, total opioid and benzodiazepines received for wound care over the first 5\u00a0days, pain\/sedation scores during wound care, time to wound closure, and readmission data. Descriptive statistics were used to assess anacaulase-bcdb treatment practices, while non-parametric tests were used for all comparisons. 13 patients treated with anacaulase-bcdb were identified. Median (interquartile range) cohort age, total body surface area, and mechanism of injury were 46\u00a0years (33.5, 59.5), 4.5% (2, 10.2), and flame (46.2%). No baseline differences were identified between groups. Anacaulase-bcdb was used before day 3 with regional anesthesia in all but 2 cases and successful eschar removal in 12 patients (92%). Patients treated with anacaulase-bcdb had a shorter time to first surgery from admission (4\u00a0days [3, 5] vs 6 [5, 7], P = .017) and higher average maximum wound care pain scores during the first 5\u00a0days (7 [6, 8] vs 5 [3, 7], P = .047). There was no difference in length of stay, area grafted, number of surgeries, total opioids\/benzodiazepines received, or sedation scores.<\/jats:p>","DOI":"10.1093\/jbcr\/iraf199","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T04:14:47Z","timestamp":1762748087000},"page":"432-436","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Experience of Anacaulase-bcdb Debridement in Burns"],"prefix":"10.1093","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7776-0268","authenticated-orcid":false,"given":"Cameron J","family":"Gibson","sequence":"first","affiliation":[{"name":"UCHealth Burn and Frostbite Center, University of Colorado Department of Surgery , Aurora, CO 80045 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott W","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Colorado Hospital , Aurora, CO 80045 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2680-9310","authenticated-orcid":false,"given":"Emily A","family":"Dorgan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Colorado Hospital , Aurora, CO 80045 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3321-3681","authenticated-orcid":false,"given":"Frederick W","family":"Endorf","sequence":"additional","affiliation":[{"name":"UCHealth Burn and Frostbite Center, University of Colorado Department of Surgery , Aurora, CO 80045 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6741-7140","authenticated-orcid":false,"given":"Alexandra E","family":"Halevi","sequence":"additional","affiliation":[{"name":"UCHealth Burn and Frostbite Center, University of Colorado Department of Surgery , Aurora, CO 80045 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3657-7504","authenticated-orcid":false,"given":"Arek J","family":"Wiktor","sequence":"additional","affiliation":[{"name":"UCHealth Burn and Frostbite Center, University of Colorado Department of Surgery , Aurora, CO 80045 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"2026030600221565600_ref1","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1097\/00005373-198405000-00001","article-title":"Burn depth estimation--man or machine","volume":"24","author":"Heimbach","year":"1984","journal-title":"J Trauma"},{"key":"2026030600221565600_ref2","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1016\/j.burns.2004.04.010","article-title":"Safety and efficacy of a proteolytic enzyme for enzymatic burn debridement: a preliminary report","volume":"30","author":"Rosenberg","year":"2004","journal-title":"Burns."},{"key":"2026030600221565600_ref3","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/j.bjps.2008.01.001","article-title":"Once upon a time ... How west discovered east","volume":"61","author":"Janzekovic","year":"2008","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"2026030600221565600_ref4","doi-asserted-by":"crossref","first-page":"e33","DOI":"10.1177\/229255031001800303","article-title":"Histological assessment of tangentially excised burn eschars","volume":"18","author":"Gurfinkel","year":"2010","journal-title":"Can J Plast Surg"},{"key":"2026030600221565600_ref5","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1016\/j.burns.2013.08.013","article-title":"A novel rapid and selective enzymatic debridement agent for burn wound management: a multi-center RCT","volume":"40","author":"Rosenberg","year":"2014","journal-title":"Burns."},{"key":"2026030600221565600_ref6","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1093\/jbcr\/irad142","article-title":"Early enzymatic burn debridement: results of the DETECT Multicenter randomized controlled trial","volume":"45","author":"Shoham","year":"2024","journal-title":"J Burn Care Res"},{"key":"2026030600221565600_ref7","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1093\/jbcr\/irae172","article-title":"Bromelain-based enzymatic debridement versus standard of Care in Deep Burn Injuries: a systematic review and meta-analysis","volume":"46","author":"Rezende de Freitas","year":"2024","journal-title":"J Burn Care Res."},{"key":"2026030600221565600_ref8","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1097\/BCR.0000000000000609","article-title":"Inhibition of bromelain activity during enzymatic debridement of burn wounds Pretreated with frequently used products","volume":"39","author":"Schulz","year":"2018","journal-title":"J Burn Care Res"},{"key":"2026030600221565600_ref9","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1016\/j.burns.2020.03.002","article-title":"Eschar removal by bromelain based enzymatic debridement (NexoBrid(R)) in burns: European consensus guidelines update","volume":"46","author":"Hirche","year":"2020","journal-title":"Burns."},{"key":"2026030600221565600_ref10","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.1016\/j.burns.2017.07.025","article-title":"Eschar removal by bromelain based enzymatic debridement (NexoBrid((R))) in burns: an European consensus","volume":"43","author":"Hirche","year":"2017","journal-title":"Burns."},{"key":"2026030600221565600_ref11","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1093\/jbcr\/iry009","article-title":"An overview of the use of bromelain-based enzymatic debridement (NexoBrid(R)) in deep partial and full thickness burns: appraising the evidence","volume":"39","author":"Loo","year":"2018","journal-title":"J Burn Care Res"},{"key":"2026030600221565600_ref12","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/j.burns.2021.05.018","article-title":"Pain management during a bromelain-based selective enzymatic debridement in paediatric and adult burn patients","volume":"48","author":"Claes","year":"2022","journal-title":"Burns."},{"key":"2026030600221565600_ref13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/ebj5010001","article-title":"Pain management during bromelain-based enzymatic debridement (NexoBrid((R))) in a USA adult burn Center","volume":"5","author":"Buta","year":"2023","journal-title":"Eur Burn J"}],"container-title":["Journal of Burn Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jbcr\/article-pdf\/47\/2\/432\/65243044\/iraf199.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbcr\/article-pdf\/47\/2\/432\/65243044\/iraf199.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T05:22:25Z","timestamp":1772774545000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbcr\/article\/47\/2\/432\/8316978"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,10]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,11,10]]},"published-print":{"date-parts":[[2026,3,4]]}},"URL":"https:\/\/doi.org\/10.1093\/jbcr\/iraf199","relation":{},"ISSN":["1559-047X","1559-0488"],"issn-type":[{"value":"1559-047X","type":"print"},{"value":"1559-0488","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2025,11,10]]}}}