title: Effect of enzymatic debridement with collagenase on acute and chronic hard-to-heal wounds.
abstract: OBJECTIVE
  A large retrospective analysis was performed to assess the outcomes of burns and chronic ulcers treated with collagenase in an outpatient setting. No cost comparison was performed.
  
  
  METHODS
  Of 979 patients entered into the analysis, 647 had burns affecting < or = 15% body surface area (BSA) and 332 had chronic ulcers of various aetiologies. AII were treated with collagenase-based ointments once daily (Noruxol or Iruxol, Smith and Nephew). Treatment was continued until complete healing was achieved.
  
  
  RESULTS
  In burns patients the overall average healing time was 17.9 days in the paediatric population and 23.6 days in adults. Burn depth and presence of eschar were the main factors affecting healing probability. The chronic ulcers were predominantly of diabetic, venous and mixed aetiology. Average healing time was 15.4 weeks, with ulcers of mixed aetiology showing the shortest average healing time (9.2 weeks). There was a positive correlation between wound area and healing time. The topical application of collagenase-based ointments was well tolerated by patients and caregivers.
  
  
  CONCLUSIONS
  This large retrospective analysis shows that collagenase treatments in outpatient clinics are effective and well accepted in patients with burns affecting < or = 15% BSA or with chronic ulcers of various aetiologies. Implementation of collagenase treatments in outpatient clinics has the potential to improve wound healing and may also decrease the cost of wound care.
authors.affiliation: Department of Tissue Therapy, Hard-To-Heal Ulcer Clinic, Niguarda Ca' Granda Hospital, Milan, Italy. mario.marazzi@ospedaleniguarda.it
authors.forename: M
authors.initials: M
authors.lastname: Marazzi
authors.forename: A
authors.initials: A
authors.lastname: Stefani
authors.forename: A
authors.initials: A
authors.lastname: Chiaratti
authors.forename: M N
authors.initials: MN
authors.lastname: Ordanini
authors.forename: L
authors.initials: L
authors.lastname: Falcone
authors.forename: V
authors.initials: V
authors.lastname: Rapisarda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D017364:Collagenases / Q000627:therapeutic use*; D003646:Debridement / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009824:Ointments; D012189:Retrospective Studies; D012883:Skin Ulcer / Q000628:therapy*; D014945:Wound Healing
chemical_list: D009824:Ointments; D017364:Collagenases