A novel enzymatic debriding agent was evaluated on experimental full-thickness porcine contact
burns. This agent consists of a highly purified,
ananain-based,
cysteine protease preparation formulated in a hydrophilic cream vehicle.
Debridement of full-thickness
burns was found to be dependent on several factors including the concentration of
enzyme in the vehicle, the
duration of treatment, and the hydration status of the
burn wound before treatment. With an optimized
debridement regimen,
burns were consistently debrided of all gelatinized tissue with two 5-hour treatments. Histologic evaluation of the debrided
wounds revealed an acellular deeper dermis that was debrided of necrotic cellular debris; however, the
collagen matrix of the deeper dermis remained intact. This observation was consistent with a demonstrated in vitro specificity of the
ananain-based
protease for
gelatin over
collagen. A direct comparison of
debridement efficacy with
sutilains ointment, showed the
ananain-based, debriding
enzyme preparation to provide more rapid
debridement of gelatinized tissue. Enzymatically debrided
wounds exhibited graft take only after surgical excision of approximately 1 mm of the remaining acellular, avascular dermis. This highly purified
enzyme preparation offers the potential for rapid nonsurgical
debridement of gelatinized
burn tissue, but required additional surgical
debridement for graft take in this porcine model.