Debriding agents

The value of proteases in cleansing tissue wounds has been appreciated for several hundred years. Wounds were sometimes cleansed in the past by application of protease-containing maggot saliva. Nowadays, this is usually more acceptably achieved by topical application of the enzyme to the wound surface. In some cases, the enzyme is formulated in an aqueous-based cream, and in others it is impregnated into special bandages. Trypsin, papain, collagenase and various microbial enzymes have been used in this regard. 

Papain is a cysteine protease isolated from the latex of the immature fruit and leaves of the plant Carica papaya. It consists of a single 23.4 kDa, 212 amino acid polypeptide, and the purified enzyme exhibits broad proteolytic activity. Although it can be used as a debriding agent, it is also used for a variety of other industrial processes, including meat tenderizing and for the clarification of beverages. 

Chymotrypsin has also been utilized to promote debridement, as well as the reduction of soft tissue inflammation. It is also used in some opthalmic procedures, particularly in facilitating cataract extraction. It is prepared by activation of its zymogen, chymotrypsinogen, which is extracted from bovine pancreatic tissue. 

Yet another proteolytic preparation used for debridement of wounds and skin ulcers consists of proteolytic enzymes derived from B. subtilis. The preparation displays broad proteolytic activity and is usually applied several times daily to the wound surface. 

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Enzymes Thrombolytic agents, digestive aids, debriding agents (i.e. cleansing of wounds)... 

Treatment of blood disorders such as haemophilia A or B Vaccination against various diseases Passive immunization against various diseases Treatment of diabetes mellitus Thrombolytic agents, digestive aids, debriding agents (i.e. cleansing of wounds)... 

Dalton, C.H., Hattersley, I.J., Payne, O., Jenner, J., Graham, J.S. (2008b). Evaluation of debriding agents against sulphur mustard (HD) injury. Proceedings of the U.S. Army Medical Defense Bioscience Review, Hunt Valley, MD, 160 pp. 

M05A B Antiinflammatory enzymes A variety of animal and plant proteases are used to reduce inflammation and swellings in wounds and abscesses after minor dental surgery, for example. The plant enzymes include papain, bromelains and ficin. These and animal enzymes such as trypsin and chy-motrypsin (pancreatic enzymes) are used as debriding agents in burn tissue, pus etc. 

J. C. Houck, C. M. Chang, and G. Klein. Isolation of an effective debriding agent from the stems of pineapple plants. Int. J. Tissue React. 5 125 (1983). 

Fibrinolysin and deoxyribonuclease, a proteolytic enzyme and a topical debriding agent, are used as a topical debridement of inflamed or infected skin lesions and wounds. 

THERA CAT Enzyme (proteolytic). Debriding agent digestive aid. Has been used to prevent adhesions as anthelmintic (Nematodes). 

The client with a venous stasis ulcer is being treated with the debriding agent dextra-nomer (Debrisan), highly porous special beads. The nurse notes the beads are a grayish-yellow color. Which action should the primary nurse implement ... 

This is a debriding agent that is working effectively therefore, no surgical debridement is necessary. 

The nurse is applying Accuzyme papain-urea, a debriding agent, to a client who has a Stage 3 pressure ulcer. Which intervention should the nurse implement ... 

When an enzymatic debriding agent is nsed under a occlusive dressing, a foul odor is produced by the breakdown of cellular debris. The nurse should explain to the client that the odor is expected. 

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