Safety and efficacy of a proteolytic enzyme for enzymatic burn débridement: a preliminary report

Rosenberg, Lior; Lapid, Oren; Bogdanov-Berezovsky, Alex; Glesinger, Ronen; Krieger, Yuval; Silberstein, Eldad; Sagi, Amir; Judkins, K.C.; Singer, Adam J.

doi:10.1016/j.burns.2004.04.010

Cited by 123 publications

(56 citation statements)

References 31 publications

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“…It is a fast-acting, reliable and complication-free enzymatic debriding agent that is capable of lysing the burn eschar within 4 h. Interestingly, bromelain removes necrotic tissue without damaging the normally healing underlying wound [6][7][8][9]. A pilot study showed that collagenase and polymyxin B sulfate may have a superior effect when compared to silver sulfadiazine alone [10].…”

Section: Discussionmentioning

confidence: 99%

Actinidia deliciosa (kiwifruit), a new drug for enzymatic debridement of acute burn wounds

Hafezi

Rad

Naghibzadeh

et al. 2010

Burns

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Section: Discussionmentioning

confidence: 99%

Actinidia deliciosa (kiwifruit), a new drug for enzymatic debridement of acute burn wounds

Hafezi

Rad

Naghibzadeh

et al. 2010

Burns

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“…72,74 While a small clinical study has shown that bromelain is a debriding agent that does not damage surrounding healthy tissue and has no significant adverse effects, the mechanism of action is still unknown. 72,75 At present Bromelain is only available outside the United States.…”

Section: Enzymatic Debridementmentioning

confidence: 99%

Optimizing Wound Bed Preparation With Collagenase Enzymatic Debridement

McCallon

Weir

Lantis

2014

Journal of the American College of Clinical Wound Specialists

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Difficult-to-heal and chronic wounds affect tens of millions of people worldwide. In the U.S. alone, the direct cost for their treatment exceeds $25 billion. Yet despite advances in wound research and treatment that have markedly improved patient care, wound healing is often delayed for weeks or months. For venous and diabetic ulcers, complete wound closure is achieved in as few as 25%-50% of chronic or hard-to-heal wounds. Wound bed preparation and the consistent application of appropriate and effective debridement techniques are recommended for the optimized treatment of chronic wounds. The TIME paradigm (Tissue, Inflammation/infection, Moisture balance and Edge of wound) provides a model to remove barriers to healing and optimize the healing process. While we often think of debridement as an episodic event that occurs in specific care giver/patient interface. There is the possibility of a maintenance debridement in which the chronic application of a medication can assist in both the macroscopic and microscopic debridement of a wound. We review the various debridement therapies available to clinicians in the United States, and explore the characteristics and capabilities of clostridial collagenase ointment (CCO), a type of enzymatic debridement, that potentially allows for epithelialization while debriding. It appears that in the case of CCO it may exert this influences by removal of the necrotic plug while promoting granulation and sustaining epithelialization. It is also easily combined with other methods of debridement, is selective to necrotic tissue, and has been safely used in various populations. We review the body of evidence has indicated that this concept of maintenance debridement, especially when combined episodic debridement may add a cost an efficacious, safe and cost-effective choice for debridement of cutaneous ulcers and burn wounds and it will likely play an expanding role in all phases of wound bed preparation.

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“…A wide range of therapeutic benefits are claimed for bromelain, introduced as a therapeutic compound since 1957. Bromelain's principle activities include: the reversible inhibition of platelet aggregation (Morita et al, 1979), fibrinolytic activity (Maurer et al, 2000), anti-inflammatory action (Inoue et al, 1994), the modulation of cytokines and immunity (Desser et al, 1994;Munzig et al, 1995), skin debridement of burns (Rosenberg et al, 2004), anti-tumour activity (Batkin et al, 1988), enhanced absorption of other drugs (Tinozzi and Venegoni, 1978), mucolytic properties (Hunter et al, 1957), a digestion aid (Knill-Jones et al, 1970), enhanced wound healing (Tassman et al, 1965) and cardiovascular and circulatory improvement (Taussig and Nieper, 1979). In addition to the cysteine protease, bromelain preparations also contains other biologically active compounds such as peroxidase, acid phosphatase, several protease inhibitors and organically bound calcium.…”

Section: Use Of Cysteine Proteases In Pharmacy and Medicinementioning

confidence: 99%