title: Quantitative and objective evaluation of wound debriding properties of collagenase and fibrinolysin/desoxyribonuclease in a necrotic ulcer animal model.
abstract: Proteolytic enzymes have been used for wound debridement for many years. The two enzymes most widely used in Europe are fibrinolysin/desoxyribonuclease and collagenase. Despite their frequent use, very few placebo-controlled studies comparing the enzymes with vehiculum only, or with each other, are available. In a specially developed necrotic ulcer animal model, combined with a computer image analysis technique to measure necrotic and total wound surface areas quantitatively, we assessed the wound-cleansing properties of fibrinolysin/DNase oleogel, collagenase ointment, saline-soaked gauze control treatment, and new galenic formulations of collagenase, including placebos. The average relative area of necrotic tissue present in the wound after 1 week was 31% for collagenase ointment and 56% for fibrinolysin/DNAse oleogel (P = 0.0037). Collagenase gel was significantly (P = 0.0007) better in removing necrosis than placebo (gel only). Fibrinolysin/DNAse was not significantly more effective than the three placebo or control treatments (placebo film, placebo gel, saline-soaked gauzes). We conclude that collagenase is a suitable enzyme for wound debridement, but we were not able to detect clinical efficacy of fibrinolysin/DNAse in this model.
authors.affiliation: Department of Dermatology, Academic Medical Center, University of Amsterdam, The Netherlands. j.r.mekkes@amc.uva.nl
authors.forename: J R
authors.initials: JR
authors.lastname: Mekkes
authors.forename: J E
authors.initials: JE
authors.lastname: Zeegelaar
authors.forename: W
authors.initials: W
authors.lastname: Westerhof
mesh_terms: D000818:Animals; D017364:Collagenases / Q000008:administration & dosage / Q000627:therapeutic use*; D003646:Debridement / Q000379:methods*; D003851:Deoxyribonucleases / Q000008:administration & dosage / Q000627:therapeutic use*; D004195:Disease Models, Animal; D005069:Evaluation Studies as Topic; D005260:Female; D005341:Fibrinolysin / Q000008:administration & dosage / Q000627:therapeutic use*; D009336:Necrosis; D012883:Skin Ulcer / Q000473:pathology / Q000628:therapy*; D013552:Swine; D014947:Wounds and Injuries / Q000473:pathology / Q000628:therapy*
chemical_list: D003851:Deoxyribonucleases; D005341:Fibrinolysin; D017364:Collagenases