9/23/2023 0 Comments Edge effect edge control![]() Therefore, we propose to substitute an enzymatic debridement agent with simple preparation, inexpensive mass production costs, high safety and better efficacy. However, there are certain risks in their use, including the possibility of partial damage to the skin around the wound, severe pain, bleeding, cellulitis and other adverse reactions 7. When selecting enzyme debridement preparations, safety, efficacy and cost effectiveness should be considered 6.īromelain and collagenase are well-studied debridement enzymes. In addition, other enzymes have been reported in several animal studies, including streptokinase/chain polysaccharide enzymes, plasminase and deoxyribonuclease. Bacteria-derived enzymes such as collagenase and matrix metalloproteinases derived from Clostridium tissoides and Bacillus subtilis have also been studied. Many enzymes have been studied, including some plant enzymes, such as bromelain and papain. Enzyme debridement refers to a method that uses exogenous enzymes with proteolytic effects to decompose and remove deactivated tissues without damaging adjacent normal tissues 5. In contrast, thorough debridement often occurs at the expense of adjacent normal tissues, leading to large tissue defects, delayed healing and even organ dysfunction 3, 4. Incomplete debridement is the root cause of postoperative wound infection. Currently, surgical debridement is still the most commonly used method of wound debridement in clinical practice, and its effect depends on the experience of the surgeon and their subjective judgment of wound contamination and necrotic tissue. Eschar removal after burns can inhibit inflammation and reduce the possibility of infection to achieve faster and better treatment of burn wounds 2. The main components of wound eschar are proteins such as collagen, fibrin, elastin, and fibronectin 1. Therefore, keratinase may have good prospects for the debridement of burn wounds. We concluded that keratinase dissolution of eschar not only has a hydrolytic effect on eschar but may also affect immune regulation to enhance the migration and phagocytosis of macrophages, promote the polarization of macrophages, and further enhance the effect of eschar dissolution. The secretion of IL-10 was increased and TNF-α was decreased, as shown by ELISA. The gene expression of the Arg-1, iNOS and IL-10 was increased, as shown by qPCR. Flow cytometry and immunofluorescence analysis showed increased expression of CD206 and Arg-1 and decreased expression of CD86 and iNOS. ![]() The number of migrated Transwell cells increased. At 12 h, the cell scratches were obviously closed. The fluorescence intensity of the keratinase group was higher than that of the control group. In bone marrow-derived macrophages (BMDMs), there was no significant difference in the activity of CCK-8 in cells in the keratinase group compared with the control group. Histopathology and immunofluorescence staining showed that the eschar in the keratinase group became thinner, inflammatory cell infiltration in the wound increased, the fluorescence intensity of the macrophage surface marker CD68 increased, and the CD163/CD86 ratio increased. We observed the wound, and keratinase shortened the time of eschar dissolution after debridement. In this study, the debridement of keratinase was examined by using a third degree burn wound model in rats. ![]() Keratinase has shown great potential in enzymatic debridement because of its good fibrin-degrading ability. ![]() ![]() At present, enzyme debridement preparation has shown a good curative effect on eschar removal of burn wounds. ![]()
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