{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T14:56:14Z","timestamp":1784300174473,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":47,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Wound Repair Regeneration"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Bromelain\u2010based enzymatic debridement (BBD) may selectively remove devitalised tissue in chronic wounds, but randomised evidence is limited. Following PRISMA and a PROSPERO\u2010registered protocol (CRD420251116455), we searched MEDLINE, CENTRAL and Embase from inception to 8 Aug 2025 for randomised controlled trials in adults with chronic wounds comparing topical BBD versus standard care\/vehicle. Two reviewers screened, extracted and assessed risk of bias. Primary outcomes were incidence of complete debridement (efficacy) and \u2265\u20091 adverse event (safety). Of 24 records, 3 RCTs (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009314) met inclusion; 2 contributed complete\u2010debridement data and 3 contributed adverse\u2010event data. BBD increased complete debridement versus control (RR 2.81, 95% CI 1.15\u20136.86; I\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200958.7). Safety was comparable (RR 1.02, 95% CI 0.76\u20131.36; I\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090), and leave\u2010one\u2010out analyses for adverse events showed no influential study. BBD improves the likelihood of complete debridement without increasing adverse events, suggesting a possible role in its use as a selective, non\u2010surgical adjunct alongside guideline\u2010directed care.\n                  <\/jats:p>","DOI":"10.1111\/wrr.70132","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T10:17:06Z","timestamp":1771323426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and Safety of Bromelain\u2010Based Enzymatic Debridement for Chronic Wounds: A Systematic Review and Meta\u2010Analysis of Randomised Controlled Trials"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8066-4427","authenticated-orcid":false,"given":"Ulgar Boran","family":"G\u00fcnay","sequence":"first","affiliation":[{"name":"Cerrahpasa Faculty of Medicine Istanbul University\u2010Cerrahpasa  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9928-1210","authenticated-orcid":false,"given":"Muhammet Kadir","family":"Tanin","sequence":"additional","affiliation":[{"name":"Cerrahpasa Faculty of Medicine Istanbul University\u2010Cerrahpasa  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6182-6939","authenticated-orcid":false,"given":"An\u0131l","family":"Demir\u00f6z","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, Cerrahpasa Faculty of Medicine Istanbul University\u2010Cerrahpasa  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(03)00303-9"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-022-00377-3"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909023411006"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.2119\/2006-00054.Brem"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2008.00438.x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12359590"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1524-475X.11.s2.1.x"},{"issue":"4","key":"e_1_2_12_9_1","article-title":"Bromelain a Potential Bioactive Compound: A Comprehensive Overview From a Pharmacological Perspective","volume":"11","author":"Chakraborty A. J.","year":"2021","journal-title":"Life (Basel)"},{"issue":"4","key":"e_1_2_12_10_1","first-page":"264","article-title":"Minimally Invasive Burn Care: A Review of Seven Clinical Studies of Rapid and Selective Debridement Using a Bromelain\u2010Based Debriding Enzyme (Nexobrid)","volume":"28","author":"Rosenberg L.","year":"2015","journal-title":"Annals of Burns and Fire Disasters"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/jbcr\/irae172"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"e_1_2_12_15_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 6.5 (Updated August 2024)","author":"Higgins J. P. 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