Ulcers papain

Medicinal Uses. One of the earliest medicinal applications of the thiol proteases was the use of fig latex as an anthelmintic agent 16, 17). In more recent times papain has been used as a digestive aid in the treatment of dyspepsia and gastric distress. Its usefulness in this respect derives from the fact that papain remains active under acid conditions and is resistant to attack by pepsin. The intraperitoneal injection of sterile solutions of papain has proved to be effective in preventing post-operative adhesions. Papain is sometimes referred to as a T io-logical scalpel because of its specific proteolytic action on dead tissue without affecting live tissue. For this reason it serves as a very useful debridement in the treatment of bums and the removal of scar tissue. When used in combination with antibiotics, it has proved to be effective for topical treatment of ulcerating and infected lesions. 

Papain has reached clinical trials for treating leg venous ulcers seen in severe diabetes. An experimental drug containing papain is being tested for safety in treating skin irritation, changes in wound debridement status, and use in possible skin grafts. 

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 ... 

Apply 1/8-inch papain ointment to the pressure ulcer. 

Bromelain has shown a wide variety of pharmacological effects in cliiucal, in vitro and in vivo studies. These effects include bum debridement, anti-inflammatory activity, prevention of epinephrine-induced pulmonary edema, smooth muscle relaxation, stimulation of muscle contractions, enhanced antibiotic absorption, immunomodulation, cancer prevention and remission, antitumor activity, ulcer prevention, sinusitis relief, appetite inhibition, shortening of labor, and enhanced excretion of fat. The precise nature of these effects (some of which are not produced by other proteases such as ficin, papain, and trypsin) is not clear. 

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