Enzymatic versus autolytic debridement of chronic leg ulcers: a prospective randomised trial.
OBJECTIVE
A randomised clinical trial (n = 42) compared the effectiveness of two approaches to debriding chronic leg ulcers: TenderWet 24, which is designed to support the autolytic degradation process, and Iruxol N (Santyl), an enzymatic treatment claimed to enhance the degradation process.


METHODS
Patients were randomly assigned to one of the two treatment groups for three weeks. Wounds were evaluated weekly for the amount of eschar/slough, the area of healthy granulation and the re-epithelialised area.


RESULTS
During days 1-14 slough within the groups was reduced by almost 19% for TenderWet 24 and by 9% for Iruxol N, followed by an increase of 26% and 10% respectively in granulation tissue. These effects were less accentuated during days 7-21. There was a further 11% improvement in tissue debridement for the TenderWet 24 group and a relapse (+9.1%) in the Iruxol N group.


CONCLUSIONS
Although TenderWet 24 appeared to be more efficient in a few cases, the general efficacy of the two products appeared to be almost the same as no statistically significant superiority of either product was found.
König
M
M
Dermatology Praxis, Gundelfingen, Germany.
Vanscheidt
W
W
Augustin
M
M
Kapp
H
H
D000368:Aged; D000553:Ambulatory Care / Q000379:methods; D001329:Autolysis / Q000503:physiopathology; D001458:Bandages / Q000592:standards*; D002701:Chloramphenicol / Q000627:therapeutic use*; D002908:Chronic Disease; D003646:Debridement / Q000379:methods*; D004338:Drug Combinations; D005260:Female; D005858:Germany; D006097:Granulation Tissue; D006801:Humans; D007871:Leg Ulcer / Q000628:therapy*; D008297:Male; D003012:Microbial Collagenase / Q000627:therapeutic use*; D011446:Prospective Studies; D017592:Skin Care / Q000379:methods*; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
D004338:Drug Combinations; D002701:Chloramphenicol; C005519:iruxol; D003012:Microbial Collagenase