Bromelain-based debridement (BBD) is advantageous compared to debridement via gel vehicle, according to a poster presented at the Symposium on Advanced Wound Care (SAWC) Spring.¹ 

The post-hoc analysis consisted of 19 patients with DFU, 12 of whom received BBD 5% and 7 of whom received a gel vehicle control.¹ Patients received treatments daily for up to 10 sessions of 4 hours (up to 2 weeks), followed by weekly assessments for 12 weeks. 

Researchers assessed complete debridement clinically and defined it as ≥90% removal of non-viable tissue within two weeks daily treatment or 100% removal anytime, notes the poster.¹ Granulation tissue assessment was clinical. Wound bed preparation (WBP) was defined as 100% removal of non-viable tissue with ≥75% granulation. Wound closure was defined as complete epithelialization without drainage or dressing use for two weeks. The subgroup analysis was not powered to detect statistically significant differences.

Researchers noted complete debridement was achieved in 58% of BBD patients vs. 14% of gel vehicle patients, during the 2 weeks daily treatment.¹ Granulation tissue ≥75% was present in 42% of BBD patients vs. 17% of gel patients. WBP anytime during the study occurred in 75% (BBD) vs. 43% (gel) and wound closure in 57% vs. 25%. The median time to complete debridement, anytime, was 23 vs. 128 days (BBD vs. gel), and the median time to WBP was 23.5 days in the BBD group vs. not reached in the gel group, according to the poster.

Researchers concluded that BBD has clinically meaningful advantages over gel vehicle in debridement, granulation tissue promotion, and wound closure for DFUs, achieving WBP faster than gel. The authors support further phase II/III studies to validate BBD for DFU management.

Reference

1. Snyder RJ, David-Zarbiv K, Haviv A, Dove C. Efficacy of bromelain-based debridement (BBD) in diabetic foot ulcers: a post hoc analysis. Presented at Symposium on Advanced Wound Care (SAWC) Spring, April 30–May 3, 2025, Grapevine, TX.