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Benefits & Drawbacks to Enzymatic Debridement

Enzymatic debridement is a modality used in the treatment of burns and severe wounds. Debridement is the removal of dead tissue from a wound which promotes healing. Enzymatic debridement, also called chemical debridement, involves the application of a cream or ointment to the wound. The action of the chemicals or enzymes contained in the cream work to loosen the dead tissue, which is then manually removed.

  1. Use of Enzymatic Debridement

    • Dead tissue inhibits wound healing and must be removed. Enzymatic debridement is typically recommended for wounds which are classified as stage III or IV. These types of wounds involve multiple layers of tissue, including all layers of skin and the underlying tissue. This type of debridement may be employed as a singular treatment or after surgical debridement of a wound.

    Types of Enzymatic Debridement

    • Most commonly used enzymatic debridement agents include Xenaderm, Santyl, Accuzyme and Panafil. The debridement chemicals or enzymes may be incorporated into creams or ointments which are directly applied to the wound bed. Chemical debridement products consist of gauze or adhesive films which are impregnated with the active agents.

    Benefits of Enzymatic Debridement

    • Enzymatic debridement is beneficial in that the product can be directly applied to the specific area to be treatment. This helps to prevent undesired damage to healthy tissue. It is considered a safe treatment in that the action is confined to the wound bed and no systemic or widespread effects are experienced. It is less painful to the patient than other types of debridement and is easy to perform. This type of debridement works quickly to dissolve or loosen the dead tissue in the wound.

    Drawbacks of Enzymatic Debridement

    • Because the enzyme is delivered by another medium (cream, ointment, dressing), there is a risk that the medium may also contain impurities or bacteria. A healing wound bed covered by an occlusive dressing may promote bacterial growth; therefore, a wound being treated using enzymatic debridement must be watched closely for signs of an infection. An infection can not only impede wound healing, it may also be deadly if the bacteria enter the bloodstream. Other drawbacks to using enzymatic debridement include the expense and limited availability (the products usually require a prescription).

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