Considerable progress has been made in the prevention and treatment of
pressure ulcers but they remain a significant healthcare problem, particularly among the elderly. Treatment may include the use of
wound dressings such as
hydrogels as well as
debridement products that contain relatively high concentrations of various
enzymes. Unlike
enzymes found in
debridement products, low concentrations of
endopeptidase enzymes can cleave to denatured
proteins. Many
endopeptidases have been reported to enhance the healing process. To evaluate the effect of a
hydrogel wound dressing containing a combination of
endopeptidases on
pressure ulcers, a 12-week prospective preliminary study was conducted involving 10
nursing home patients with Stage II (n = 3) or Stage III (n = 7)
ulcers that had failed to respond to previous treatments. Seven subjects (three with Stage II
ulcers and four with Stage III
ulcers) completed the study. Healing was based on
wound closure by re-epithelialization as determined by area measurement and clinical assessment. All three Stage II
ulcers and two of the Stage III
ulcers healed completely; four Stage III
ulcers were categorized as healing (>60% improvement) after 12 weeks of care. No dressing-related adverse events occurred and subject acceptance of the product, including comfort, was high. These results suggest that additional studies designed to define the possible contribution of
endopeptidase enzymes in wound healing are warranted.