[Conditioning of chronic wounds with proteolytic enzymes]

In the past few years, several different proteolytic enzymes have been shown to be effective in conditioning the chronic wound beds. The use of proteolytic enzymes in wound-bed preparation enables a selective painless debridement. Moreover multiple positive effects on formation of granulation tissue and re-epithelialization have been observed. Therefore, a faster overall healing of chronic wounds may result. Moreover, numerous positive effects on a rapid induction of granulation are discussed. The supporting data do not fulfill the criteria of evidence-based medicine. For most chronic wounds today, enzymatic debridement represents a first choice method especially for outpatients and perhaps in combination with surgical debridement.