Denatured and necrotic extracellular matrix and tissue proteins in burn eschar

Denatured and necrotic extracellular matrix and tissue proteins in burn eschar represent the primary pathological substrate resulting from severe thermal injury (StatPearls, 2023). This target is composed of a heterogeneous mixture of heat-damaged proteins, predominantly collagen, which have lost their structural integrity and biological function (PubMed, PMID: 31543258). The presence of this necrotic tissue, or eschar, inhibits the natural healing process by acting as a physical barrier and providing a medium for microbial colonization (NIH, 2021). In the field of burn care, these proteins are the specific targets for enzymatic debridement agents like bromelain-based concentrates (Anacaulase-bcdb) and collagenases (Collagenase clostridium histolyticum) (FDA, 2022). These drugs work by selectively cleaving the peptide bonds within the denatured proteins, effectively liquefying the eschar to facilitate its removal without damaging the underlying viable dermis (Journal of Burn Care & Research, 2019). Successful degradation of this target is critical for wound bed preparation, allowing for earlier assessment of burn depth and subsequent skin grafting or spontaneous healing (PubMed, PMID: 28430162). Therapeutic management of this target aims to reduce the surgical burden and systemic inflammatory response associated with traditional sharp debridement (Burns Journal, 2020).

Other names

Burn escharNecrotic tissueDevitalized tissueDenatured collagenNecrotic wound debris

Enzymatic proteolysis and hydrolysis of denatured proteins