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Enzymatic debriding agents are safe in wounds with high bacterial bioburdens and stimulate healing.

Payne WG, Salas RE, Ko F, Naidu DK, Donate G, Wright TE, Robson MC - Eplasty (2008)

Bottom Line: Collagenase- and papain-urea-treated wounds demonstrated a reduction in bacterial burden of wounds to < 10(5) colony forming units/gram of tissue (P < .05).Wounds treated with enzymatic debriding agents healed significantly faster and to greater extent than saline-treated controls (P < .01); a direct reflection of the decreasing bacterial load of the wound.Collagenase and papain-urea appear beneficial and safe even in wounds with high bacterial loads, and appear to significantly aid extent and rate of healing, probably by lowering bacterial burden through their positive enzymatic actions on bacteria and necrotic tissue.

View Article: PubMed Central - PubMed

Affiliation: Institute for Tissue Regeneration, Repair, and Rehabilitation, Bay Pines VA Medical Center, Bay Pines, FL, USA. wyattgpayne@yahoo.com

ABSTRACT

Background: Debridement is essential for successful wound management. Enzymatic debridement is commonly utilized in wound care but has been reported to be unsafe in wounds with significant bacterial bioburden, unless used in conjunction with topical antimicrobials. We examine this hypothesis with 2 commercially available, commonly used preparations of enzymatic debriding agents.

Materials and methods: Using a standard rodent model of a chronically infected granulating wound with bacterial levels greater than 1 x 10(5) Colony Forming Units per gram of tissue, commercially available preparations of collagenase and papain-urea were utilized to investigate the response of infected wounds to these preparations, and to evaluate their ability to overcome the inhibition of infection on wound healing. Quantitative bacteriology of tissue biopsies and wound healing trajectories were used to compare the preparations to saline-treated negative controls.

Results: Collagenase- and papain-urea-treated wounds demonstrated a reduction in bacterial burden of wounds to < 10(5) colony forming units/gram of tissue (P < .05). This decrease in bacterial bioburden occurred rapidly, allowing wounds to achieve bacterial balance in a short period of time. Wounds treated with enzymatic debriding agents healed significantly faster and to greater extent than saline-treated controls (P < .01); a direct reflection of the decreasing bacterial load of the wound.

Conclusions: Collagenase and papain-urea appear beneficial and safe even in wounds with high bacterial loads, and appear to significantly aid extent and rate of healing, probably by lowering bacterial burden through their positive enzymatic actions on bacteria and necrotic tissue.

No MeSH data available.


Related in: MedlinePlus

Wound closure rates for chronic granulating wounds treated with isotonic sodium chloride solution (control), collagenase, and papain-urea. Statistically significant accelerated closure rates and extents for wounds treated with collagenase or papain-urea versus saline control.
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Figure 2: Wound closure rates for chronic granulating wounds treated with isotonic sodium chloride solution (control), collagenase, and papain-urea. Statistically significant accelerated closure rates and extents for wounds treated with collagenase or papain-urea versus saline control.


Enzymatic debriding agents are safe in wounds with high bacterial bioburdens and stimulate healing.

Payne WG, Salas RE, Ko F, Naidu DK, Donate G, Wright TE, Robson MC - Eplasty (2008)

Wound closure rates for chronic granulating wounds treated with isotonic sodium chloride solution (control), collagenase, and papain-urea. Statistically significant accelerated closure rates and extents for wounds treated with collagenase or papain-urea versus saline control.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2311452&req=5

Figure 2: Wound closure rates for chronic granulating wounds treated with isotonic sodium chloride solution (control), collagenase, and papain-urea. Statistically significant accelerated closure rates and extents for wounds treated with collagenase or papain-urea versus saline control.
Bottom Line: Collagenase- and papain-urea-treated wounds demonstrated a reduction in bacterial burden of wounds to < 10(5) colony forming units/gram of tissue (P < .05).Wounds treated with enzymatic debriding agents healed significantly faster and to greater extent than saline-treated controls (P < .01); a direct reflection of the decreasing bacterial load of the wound.Collagenase and papain-urea appear beneficial and safe even in wounds with high bacterial loads, and appear to significantly aid extent and rate of healing, probably by lowering bacterial burden through their positive enzymatic actions on bacteria and necrotic tissue.

View Article: PubMed Central - PubMed

Affiliation: Institute for Tissue Regeneration, Repair, and Rehabilitation, Bay Pines VA Medical Center, Bay Pines, FL, USA. wyattgpayne@yahoo.com

ABSTRACT

Background: Debridement is essential for successful wound management. Enzymatic debridement is commonly utilized in wound care but has been reported to be unsafe in wounds with significant bacterial bioburden, unless used in conjunction with topical antimicrobials. We examine this hypothesis with 2 commercially available, commonly used preparations of enzymatic debriding agents.

Materials and methods: Using a standard rodent model of a chronically infected granulating wound with bacterial levels greater than 1 x 10(5) Colony Forming Units per gram of tissue, commercially available preparations of collagenase and papain-urea were utilized to investigate the response of infected wounds to these preparations, and to evaluate their ability to overcome the inhibition of infection on wound healing. Quantitative bacteriology of tissue biopsies and wound healing trajectories were used to compare the preparations to saline-treated negative controls.

Results: Collagenase- and papain-urea-treated wounds demonstrated a reduction in bacterial burden of wounds to < 10(5) colony forming units/gram of tissue (P < .05). This decrease in bacterial bioburden occurred rapidly, allowing wounds to achieve bacterial balance in a short period of time. Wounds treated with enzymatic debriding agents healed significantly faster and to greater extent than saline-treated controls (P < .01); a direct reflection of the decreasing bacterial load of the wound.

Conclusions: Collagenase and papain-urea appear beneficial and safe even in wounds with high bacterial loads, and appear to significantly aid extent and rate of healing, probably by lowering bacterial burden through their positive enzymatic actions on bacteria and necrotic tissue.

No MeSH data available.


Related in: MedlinePlus