Streaming of proteolytic enzyme solutions for wound debridement: A feasibility study

The effective enzymatic digestion of extracellular matrix for the preparation of cell cultures paved the way to its application for skin treatment and wound debridement, encouraged by the selectivity observed for the separation of dermis from epidermis or the removal of necrotic tissue from wound bed without damage to healthy tissue. Proteases, such as papain and collagenase, mostly formulated as ointments, were successfully employed for wound debridement, achieved within several days of repeated treatments. Here, we propose and provide feasibility demonstration of a new mode of enzyme application for skin treatment and wound debridement: continuous controlled streaming of enzyme solutions onto an enclosed treated area. The working hypothesis is that the combination of fresh supply of enzymes in optimal working buffer with continuous flow will substantially shorten the time required for effective treatment, e.g., from days or weeks to hours, as well as simplify handling and processing. The feasibility of enzyme streaming and its efficacy are demonstrated in targeted selective intact skin digestion, removal of coagulated blood, and debridement of experimental burn wounds in lab animals. Selective skin digestion and burn wound debridement with minimal handling were readily achieved within 2 to 3 hours by streaming diluted protease solutions at slow flow rates. This simple and straight-forward mode of operation carries potential for the improvement of wound bed management. The use of this streaming technique may facilitate delivery of cleaning solutions, enzymatic debriders, or irrigation fluids for wound bed preparation.