title: A new association between hyaluronic acid and collagenase in wound repair: an open study.
abstract: BACKGROUND
  Most ulcers occur with slough and need debridement treatment. Surgical treatment is usually performed but many patients need an additional chemical therapy to promote healing process. This type of wound bed preparation is slower than surgical one, but it is essential in those patients who are not eligible for surgery because of systemic diseases. A collagenase derived from the bacterium Clostridium hisolyticum is the most used.
  
  
  OBJECTIVE
  To evaluate the safety and the effectiveness of a new collagenase produced by Vibrio algynoliticum.
  
  
  METHODS
  Forty patients were enrolled and daily treated for five weeks with Bionect Start® ointment. Parameters took into account were fibrin degradation and pain relief. The same team carried out treatment during the study period of five weeks.
  
  
  RESULTS
  32 patients achieved a relevant reduction of the ulcer size, an improvement of the wound bed and a reduction of fibrin and exudates. Among of 32, 14 patients presented with a complete healing. Eight patients had mild or no improvements. The patients referred a remarkable pain reduction, 20 out of 40 patients reported a decrease in pain during treatment, 16 patients referred no pain at all and four patients had no significant changes.
  
  
  CONCLUSIONS
  The application of this product on the lesions promotes vascularized granulation tissue and reduces formation of fibrin and exudate. Furthermore, a macroscopical margins proliferation is highlighted after a short time and an improvement of periwound skin is observed during the treatment period. Bionect Start® allowed easy removal of dressing, less pain for patient, reduction of dressing time.
authors: Department of Plastic and Reconstructive Surgery, University of Rome Sapienza, Policlinico Umberto I, Rome, Italy.
authors: M G
authors: MG
authors: Onesti
authors: P
authors: P
authors: Fioramonti
authors: S
authors: S
authors: Carella
authors: P
authors: P
authors: Fino
authors: V
authors: V
authors: Sorvillo
authors: N
authors: N
authors: Scuderi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017364:Collagenases / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009824:Ointments; D012883:Skin Ulcer / Q000188:drug therapy*; D044149:Vibrio alginolyticus / Q000201:enzymology*; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D009824:Ointments; D006820:Hyaluronic Acid; D017364:Collagenases