collagenase ointment (SANTYL)

Indications

• debridement of chronic cutaneous ulcers & severely burned areas
  • diabetic foot ulcers

Contraindications

• local or systemic hypersensitivity to collagenase
• not indicated for wound closure

Caution:

• for external use only
• avoid contact with eyes
• monitor debilitated patients; debriding enzymes may increase risk of bacteremia

Dosage

• topical, apply QD
• discontinue use when granulation tissue is well-established

Ointment: 250 units/g. 15 & 30 g.

Pharmacokinetics

• optimal pH range of collagenase is 6-8

Adverse effects

• theoretical possibility collagenase may increase the risk of bacteremia
• transient erythema especially if collagenase not confined to wound

Drug interactions

• detergents
• benzalkonium chloride
• hexachlorophene
• nitrofurazone
• tincture of iodine
• heavy metal ions such as mercury & silver used in some antiseptics

Mechanism of action

• digestion of collagen (75% of dry weight of skin tissue) facilitates removal of detritus from cutaneous wounds

More general terms

• collagenase
• musculoskeletal system agent

Additional terms

• collagenase clostridium histolyticum (CCH, Xiaflex, Qwo)