[Enzymatic debridement of wounds. Comparison of 2 commercial preparations]

In a randomized single-blind trial 44 patients of the Unfallchir. Klinik of Wiesbaden with purulent exudates and/or necrotic substrates in wounds had been enzymatically debrided with preparation A or B (22 patients each group). The solutions had been applied topically in a wet-to-dry technique. Dressings were changed two times a day, until the area became clean and showed granulations. In the group treated with preparation A excellent and good results could be obtained in 16 patients, in the comparison group in 14 patients. Three patients in the group treated with preparation A remained unchanged; in the comparison group five patients remained unchanged or showed deterioration. Due to inefficiency or to side effects treatment was interrupted in four patients of the preparation A-group and in eight patients of the comparison group. The more satisfactory results with preparation A can be interpreted in regard to the action of the enzymes: Fibrinolysin immediately attacks the fibrin of blood clots and fibrinous exudates. Desoxyribonuclease assails desoxyribonucleic acid structures. Streptokinase and streptodornase however are needing plasminogen for transforming it into the effective enzyme of plasmin, as they themselves are uneffective. And the amounts of plasminogen in the treated wounds possibly are not sufficient.