A 61-year old male was presented at our Burn Centre with a severe burn injury affecting 95% TBSA second to third degree. On admission, a mechanical debridement, an escharotomy and a tracheotomy were performed. Due to acute respiratory and cardiac failure, no surgical intervention could be performed in the next few days. Thus, a fractional use of enzymatic debridement with Nexobrid was performed to a TBSA of 54% starting on Day 5: Day 5: upper limbs (20% TBSA); Day 7: lower legs and feet (17% TBSA); Day 8: upper legs (17% TBSA).  Despite successful enzymatic debridement, the patient died on Day 8 due to acute lung and heart failure.
This Case report reveals that a delayed and fractional application of Nexobrid to a TBSA of more than 15% is possible.

Delayed and fractional use of enzymatic debridement with Nexobrid for extensive burn injury: A Case report