Proteases, wound debridement

Papain—a plant protease derived from the papaya fruit. The enzyme is used in digestive aids, wound debridement, tooth-cleaning and. most importantly, as a meat tenderizer. 

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. 

The key treatment for diabetic foot wounds is often debridement in its many guises. Despite the plethora of treatment available their success can be limited if the wound is not sufficiently prepared. The process of debridement removes non-viable tissue and the products remaining from an abnormal, sustained inflammatory response. Increased protease levels and an imbalance of matrix metal-loproteinases and their tissue inhibitors [10] maintain the chronic wound state and their removal with associated hyperaemia will encourage an influx of the biological components of healing. The level of debridement used will depend on the aetiopathogenesis and the morphology of the ulcer. 

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