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Testing Elevated Protease Activity: Prospective Analysis of 160 Wounds.

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  • 1In the Department of Dermatology, Venereology, and Allergology at University Medical Center Göttingen, Germany, Anike Lockmann, MD, is an Assistant Physician; Tillmann Schill, MD, is a Specialist Physician; Franziska Hartmann, MD, is an Assistant Physician; Lisa-Lena Grönemeyer, MD, is an Assistant Physician; Michael P. Schön, MD, is Professor and Chairman; and Kai-Martin Thoms, MD, is a Senior Physician. Ricarda Holzkamp, MD, is a Specialist Physician, Dermatology Practice, Osterode, Germany. Acknowledgments: Kai-Martin Thoms has disclosed speaker's fees from Systagenix Wound Management. Woundchek Protease Status was purchased at a reduced price for the purpose of this study. The authors have disclosed no other conflicts of interest regarding this article. Submitted December 21, 2016; accepted in revised form June 21, 2017.

Advances in Skin & Wound Care
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Elevated protease activity (EPA) was found in nearly 19% of wounds, particularly in acute nonsurgical wounds. Early detection of EPA may guide protease-modulating treatments to improve wound healing outcomes.

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Area of Science:

  • Wound healing research
  • Biochemistry of wound repair
  • Dermatology and tissue regeneration

Background:

  • Elevated protease activity (EPA) is linked to impaired wound healing.
  • Understanding EPA prevalence across different wound types is crucial for effective treatment strategies.

Purpose of the Study:

  • To prospectively assess the prevalence of local EPA in various wound types.
  • To investigate the relationship between EPA and wound characteristics, healing signs, and dressing types.

Main Methods:

  • A single-center study involving 143 patients and 160 wounds.
  • Utilized the Woundchek Protease Status Test Kit to detect combined inflammatory protease activity (MMPs 8/9, HNE).

Main Results:

  • EPA detected in 18.95% of wounds.
  • Surgical wounds showed significantly less EPA than nonsurgical wounds.
  • Acute nonsurgical wounds and wounds with necrotic/fibrin tissue had higher EPA rates.
  • Moisture-retentive dressings and protease-modulating dressings (collagen/oxidized regenerated cellulose/silver) were associated with lower EPA.
  • 14% of wounds with granulation/epithelialization still exhibited EPA.

Conclusions:

  • This study represents the largest assessment of EPA across diverse wound types.
  • The test system's ease of use supports further research into EPA's pathophysiologic role.
  • Early EPA detection can potentially guide protease-modulating therapies to prevent healing failure.