What Is Collagenase Santyl Used For?

Collagenase Santyl is an FDA-approved prescription medicine that helps remove dead, damaged, or infected tissue from wounds so they can start to heal properly. This enzymatic debriding agent is uniquely formulated to target and dissolve necrotic tissue while sparing healthy tissue.

Collagenase Santyl has been used for over 50 years to effectively debride chronic skin ulcers and severely burned areas. It is the only enzymatic debriding ointment proven to help move difficult-to-heal wounds toward closure by clearing away debris and enabling the body’s natural healing process.

How Does Collagenase Santyl Work?

Collagenase Santyl contains a purified bacterial collagenase enzyme derived from the fermentation by Clostridium histolyticum. This enzyme has a unique ability to break down collagen, which is a key component of the extracellular matrix that holds skin and tissue together.

When applied topically, the collagenase in Santyl selectively digests non-viable collagen in necrotic tissue, liquefying it so it can be removed. This debrides or cleans out dead tissue, fibrin coatings, eschar, and other material that can impair wound healing.

Collagenase does not affect viable tissue or completely dissolve healthy collagen. This makes it highly selective for digesting only denatured collagen in non-living tissue. It cleaves the collagen into small peptides and amino acids which can then be easily removed from the wound bed.

The debriding action of collagenase Santyl creates an environment better suited for healing by:

  • Exposing healthier underlying tissue – Necrotic tissue removal enables better assessment and care.
  • Promoting granulation – Removing debris allows new tissue to form.
  • Reducing bioburden – Less dead tissue means fewer bacteria.
  • Enabling drainage – Liquefied material can drain away.
  • Enhancing efficacy of topical medicines – Better penetration into cleared wounds.

What Types of Wounds Can Collagenase Santyl Treat?

Collagenase Santyl is used to debride a variety of chronic, hard-to-heal wounds including:

  • Diabetic foot ulcers – These ulcers commonly occur in people with diabetes most often on the bottom of the foot. If not properly treated, they can lead to serious infections and amputations.
  • Pressure ulcers (bedsores) – These skin lesions develop from constant pressure and friction typically over bony areas like the heels, hips, and tailbone. They can range from mild irritation to severe open craters down to the bone.
  • Venous stasis ulcers – These ulcers happen due to improper vein function causing blood to pool in the legs. The skin breaks down leading to ongoing open sores.
  • Arterial ulcers – These painful ulcers result from reduced arterial blood flow. The skin does not get enough oxygen and nutrients to heal.
  • Post-surgical wounds – Some wounds after surgery do not heal properly due to underlying health issues. Offloading healthy tissue is key.
  • Traumatic wounds – Severe wounds from accidents, burns, or combat trauma often contain substantial dead tissue impeding recovery.
  • Other chronic dermal ulcers – Various skin ulcerations unresponsive to other treatments may benefit from enzymatic debridement.

Collagenase Santyl helps transform these previously static wounds by removing thick layers of seemingly unaffected dead tissue preventing progress.

Why Use Collagenase Santyl for Debridement?

There are a few different methods available for debriding chronic wounds, but collagenase ointment has some major advantages:

  • Highly selective – Collagenase Santyl only affects necrotic tissue, not healthy tissue. This allows for more aggressive debridement.
  • Effective on recalcitrant wounds – Collagenase is proven to debride wounds unresponsive to other methods. It works on thick eschar and fibrin.
  • Painless debridement – Santyl gently enzymatically loosens necrotic tissue without harming nerves or sensitive underlying granulation.
  • Simple ambulatory treatment – Santyl is easy for patients to self-administer without needing anesthesia or trips to the OR.
  • No special skill required – Any trained healthcare provider can apply Santyl. Does not require a wound specialist.
  • Promotes healing – By removing barriers to healing and infection, Santyl creates an optimal environment for wounds to start closing.
  • Clinically supported – Decades of clinical evidence support collagenase as a standard of care for debriding chronic dermal ulcers.

Santyl stands out from other approaches like surgical/sharp debridement, autolysis, or hydrogels which have limitations in their ability to selectively and thoroughly remove necrotic tissue binding severely impaired wounds.

How To Use Collagenase Santyl

Collagenase Santyl comes as a lightweight, water-soluble ointment. It is typically prescribed by doctors for outpatient use following this simple protocol:

Step 1: Cleanse

First, thoroughly cleanse the wound and surrounding skin according to clinical protocol. Remove any loose debris or drainage. Pat the area dry.

Step 2: Apply Santyl

Use a gauze pad or wooden spatula to gently apply a thin layer of Collagenase Santyl directly to the wound surface and contiguous non-viable tissue.

Do not rub hard or abrade as this can disrupt newly formed granulation tissue. Completely cover the area needing debridement.

Step 3: Dress and Bandage

Cover the Santyl ointment with a sterile dressing or non-adherent pad. Wrap with gauze roll or other secondary dressing. Bandage to hold everything in place.

Step 4: Let Act

Leave the Santyl undisturbed for at least 8 hours, up to 12 hours. This gives the ointment time to thoroughly digest necrotic debris.

Step 5: Remove

Carefully remove the bandages, Santyl, and loosened debris. Cleanse to remove drainage and any remaining ointment. Repeat process daily.

  • Treatment generally continues until healthy granulation tissue is seen.
  • Change the ointment container every three months even if unused.

How Long Does Collagenase Santyl Take To Work?

Collagenase Santyl starts working immediately to dissolve necrotic collagen when applied. However, it usually takes several applications over a period of 1-2 weeks to achieve complete debridement of chronic ulcers.

The time depends on:

  • Wound severity – Milder wounds debride faster than deeply embedded eschar.
  • Frequency of application – Applying Santyl daily is more effective than every 2-3 days.
  • Dressing changes – Frequent cleansing removal of debris quickens the process.
  • Patient factors – Medical issues like diabetes or medications can affect debridement.

With continued use, Santyl progressively softens and lifts away thicker layers of dead tissue until healthy granulation is unveiled. Your doctor will monitor and determine when satisfactory debridement has occurred.

What Are The Side Effects of Collagenase Santyl?

When used as directed, Collagenase Santyl is generally well tolerated with minimal side effects. Possible adverse reactions include:

  • Mild irritation at the application site – Redness, itching, oozing or swelling where Santyl is applied. Typically resolves within 1-2 days.
  • Increased drainage from the debrided wound – Loosened necrotic tissue may increase drainage which subsides once debridement is complete.
  • Bleeding – Minor bleeding can occur after debriding eschar near blood vessels. Usually self-limiting.
  • Pain or discomfort – Some patients report mild pain as Santyl debrides which normally dissipates rapidly.
  • Skin maceration – Oversoftening of periwound skin if Santyl gets beyond wound margins. Prevent by protecting surrounding skin.
  • Allergic reaction – Though rare, abnormal immune response could occur if allergic to product ingredients. Discontinue use.

Serious reactions are unlikely. But immediately tell your doctor about any concerning symptoms that do not quickly resolve. Overall, the benefits of rapid, effective debridement far outweigh the minimal risks.

Who Should Not Use Collagenase Santyl?

Collagenase ointment is contraindicated in some patients:

  • Those allergic to collagenase, chlorocresol, or other ingredients.
  • People with osteomyelitis (bone infection) in conjunction with deep foot ulcers. The infection could spread.
  • Impaired wound healing diseases where debridement may exacerbate issues.
  • Presence of neoplasm (cancerous cells) – May disrupt tumor growth.
  • Excessive fibrin production unless also receiving treatment. Dense fibrin removal alone can increase bleeding.

Talk to your doctor before using Santyl if you have any medical concerns, are debilitated, have advanced circulatory diseases, or are taking anticoagulants. Ulcers in fragile patients should be carefully monitored during treatment.

Key Takeaways About Collagenase Santyl

  • Collagenase Santyl is an FDA approved enzymatic debriding ointment that selectively removes dead tissue from chronic skin ulcers and severely burned areas.
  • It contains purified collagenase that breaks down damaged collagen in necrotic tissue without harming healthy tissue.
  • Santyl is applied topically once daily and left on for 8-12 hours to dissolve eschar and fibrin debris so the wound can finally progress.
  • Clinical evidence over decades supports the efficacy and safety of Santyl for debriding all types of recalcitrant wounds unresponsive to other methods.
  • Regular use of Santyl creates an optimal healing environment in stagnant wounds by removing necrotic barriers, drainage, and bacteria.
  • Doctors prescribe Santyl because it provides selective, painless, effective debridement without needing surgery or wound specialists.

Collagenase Santyl stands as a proven enzymatic debriding agent to jump start healing in chronic dermal ulcers that have become stuck in the inflammatory stage. By liquefying and clearing away dead tissue, Santyl helps restart the body’s natural healing cascade


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