This treatment has the ability to save patients from surgical debridement, infection risk, possible sepsis, escheratomies, and a host of other complications from surgery. This is beneficial to me because from my experience some patients are not medically clear to have surgery, but are scheduled anyway because of the severity of their burn. I have seen patients who are under-debrided and some who were excised to aggressively, and were hemodynamically unstable afterwards. The fact that NexoBrid only removes the nonviable tissue is next level. I think that BBD treatments such as this one will continue to change the world of burn care (Shoham et al, 2023).

Shoham, Y., Gasteratos, K., Singer, A. J., Krieger, Y., Silberstein, E., & Goverman, J. (2023). Bromelain‐based Enzymatic Burn Debridement: A systematic review of clinical studies on patient safety, efficacy and long‐term outcomes. International Wound Journal, 20(10), 4364–4383. https://doi.org/10.1111/iwj.14308 

Smolle, C., Wurzer, P., Tuca, A., Shoham, Y., Voigt, C. D., Branski, L. K., Lumenta, D., & Kamolz, L.-P. (2015). Low exposure levels of respirable particles during the preparation of NexoBrid® Bromelain powder. Safety in Health, 1(1). https://doi.org/10.1186/s40886-015-0012-3

In addition, research conducted by Smolle et al., (2015) found that there is a risk of an allergic reaction when the bromelian powder is inhaled. It is recommended that all patients who are allergic to pineapples avoid this product. Oral bromelian has also been proven to reduce platelet aggregation, plasma fibrinogen, prothrombin, and activated partial thromboplastin times (aPTT). In light of this discovery healthcare providers should avoid or exercise with caution on patients taking anticoagulants with thrombocytopenia, or in other causes of increased risk of bleeding.

NexoBrid also has limits of where it can be utilized. According to the NexoBrid (2023) this medication cannot be used of the following burns or conditions:

• Burns on the face, perineum, or genitalia

• Burns on the feet of patients with diabetes mellitus or on the feet of patients with occlusive vascular disease

• Circumferential burns

• Burns in patients with significant cardiopulmonary

  disease, including inhalation injury

• Electrical burns

This is significant because a large portion of the burn patients I see have comorbidites, and frequently have burns on these ares where NexoBrid cannot be used.

• Context

• Harmoney

• Consitencey

• Learner

• Achiever

  My strengths are instrumental in achieving educational success as they allow me to learn from the past and apply those lessons to the future. I strive to create a positive work environment by avoiding conflicts and maintaining harmony. Consistency and discipline are crucial to me, whether working independently or in groups, as they are the keys to achieving goals. I have a thirst for knowledge and consider myself a lifelong learner, constantly seeking new information and data. To excel in education, one must have a natural inclination towards learning. Additionally, my ability to remain dedicated and focused on tasks makes me a valuable asset in a team setting where perseverance is essential for completing assignments that require extensive time and research.

The top 5 Strengths/People I chose:

• Carter-Communication

• Pablo-Positivity

• Fernado-Focus

• Daniel-Discipline

• Sam-Self-Assurance

I carefully selected these individuals based on their strengths, which I believe complement areas where I may be lacking in my educational journey. Communication in group settings is a skill I struggle with, so having a team member who excels in this area would greatly benefit our collaboration. Positivity is crucial for me, as I believe it is essential for success in any endeavor. Discipline is a constant challenge for me, given the numerous demands on my time. Having a team member who can help keep me focused and on track would be invaluable. Self-Assurance is vital for building confidence and achieving educational goals. Having a team member with this strength would not only boost my confidence but also help alleviate any anxiety I may feel during group work.