Burn wound eschar proteins

Burn wound eschar proteins represent the necrotic, denatured proteinaceous material that forms on the surface of skin following a deep-partial or full-thickness thermal injury. This complex substrate is primarily composed of thermally damaged extracellular matrix (ECM) components, such as denatured collagen, fibrin, and elastin, which lose their native structure and function (Singer et al., 2017, Journal of Burn Care & Research). The presence of eschar is pathological as it prevents the formation of granulation tissue and serves as a reservoir for microbial colonization (StatPearls, 2023, Burn Resuscitation and Management). Furthermore, thick eschar can cause mechanical constriction, potentially leading to compartment syndrome in circumferential burns. Pharmacologically, these proteins are the primary target for enzymatic debridement agents like NexoBrid, which is a concentrate of proteolytic enzymes enriched in bromelain (EMA, 2012, NexoBrid Assessment Report). These therapeutic agents work by selectively hydrolyzing the peptide bonds within the denatured eschar proteins, facilitating the non-surgical removal of dead tissue while preserving viable dermal structures. Effective targeting of these proteins is crucial for preparing the wound bed for subsequent healing or surgical grafting. Compared to surgical excision, enzymatic targeting of eschar proteins can reduce blood loss and the need for autografting.

Other names

Burn escharNecrotic burn tissueDevitalized tissue proteinsDenatured extracellular matrix proteins

Enzymatic proteolysis and degradation of denatured protein components within the necrotic tissue to facilitate debridement.