Collagenase in the Treatment of Dermal and Decubitus Ulcers

Abstract

The current management of decubitus ulcers, factors in wound healing and the role of enzymes in treatment are discussed. The therapeutic benefits of collagenase (Santyl) ointment in 21 patients are described, supplemented by serial color photographs. Statistical evidence is provided for the conclusion that collagenase ointment is an excellent adjunct to therapy.

Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum

“…Enzymatic débridement, which does not require a trained clinician for application, has been found in several studies to remove nonviable tissue from VLU wound beds, but there is no evidence that this method provides a benefit over surgical débride-ment. [231][232][233] In clinical trials, larval therapy along with compression has been shown to be an effective method of débridement. However, the use of larval therapy did not increase the rate of healing for necrotic tissue or slough in leg ulcers compared with ulcers treated with hydrogel and compression.…”

Degradation of human collagen isoforms by Clostridium collagenase and the effects of degradation products on cell migration

“…In addition to being a valuable tool in the laboratory (6,7), Clostridium collagenases have found clinical application as a wound debriding enzyme for decades (8,9). Many cases of successful wound applications of the crude enzyme in an ointment base are illustrated in the treatment of third‐degree burns (10,11), soft tissue and pressure ulcers (12–16), diabetic ulcers (17) or venous stasis, and ischemic arterial ulcers (18–20). These applications with Clostridium collagenase have been shown to provide effective debridement in treating various wounds.…”

Diversity, Structures, and Collagen-Degrading Mechanisms of Bacterial Collagenolytic Proteases

“…Clostridium collagenase has been used in laboratories to dissociate tissues and isolate cells (89) and used as a therapeutic drug for the removal of necrotic wound tissues for several decades (90,91). It is successfully applied in the treatment of third-degree burns (92,93), soft tissue and pressure ulcers (94)(95)(96)(97), diabetic ulcers (98), ischemic arterial ulcers (99)(100)(101), and Dupuytren's disease (102). Recently, clostridial collagenases (Xiaflex/Xiapex) were approved by both the FDA (December 2013) and the European Union (February 2015) to be used as nonsurgical treatment for Peyronie's disease.…”