Bromelain-based enzymatic debridement: mechanism of action in the wound environment. A literature review.

Background: Chronic hard-to-heal wounds, such as diabetic foot ulcers, venous leg ulcers, and pressure ulcers, present significant safety concerns, patient burdens, and challenges to health care systems globally.

Objective: To review the mechanism of action and clinical function of bromelain-based enzymatic debridement (BBD) in the context of wound care, focusing on the mechanism of action of BBD and its formulation for chronic wounds in particular.

Methods: A literature review was conducted to assess both bromelain's mechanism of action as well as clinical and preclinical studies on the use of BBD, searching the PubMed and Google Scholar databases for articles published between November 1992 and July 2024.

An open-label, proof-of-concept study assessing the effects of bromelain-based enzymatic debridement on biofilm and microbial loads in patients with venous leg ulcers and diabetic foot ulcers.

Background: Most chronic wounds contain biofilm, and debridement remains the centerpiece of treatment. Enzymatic debridement is an effective tool in removing nonviable tissue, however, there is little evidence supporting its effect on planktonic and biofilm bacteria.

Objective: This study evaluated the effects of a novel BBD agent on removal of nonviable tissue, biofilm, and microbial loads in patients with chronic ulcers.

Insulin receptor plays a central role in skin carcinogenesis by regulating cytoskeleton assembly.

Diabetes mellitus prevalence is increasing rapidly and is a major cause of mortality and morbidity worldwide. In addition to the known severe complications associated with the disease, in recent years diabetes has been recognized as a major risk factor for cancer. Patients with diabetes experience significantly higher incidence of and higher mortality rates from many types of cancer.