{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T02:15:03Z","timestamp":1790475303405,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T00:00:00Z","timestamp":1743292800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Chronic wounds, including diabetic foot ulcers, pressure ulcers, and burn injuries, present significant challenges for healthcare systems, with debridement being crucial for healing. This review compares the efficacy of autolytic and enzymatic debridement techniques. The objective was to assess clinical outcomes related to both methods, focusing on wound size reduction, granulation tissue formation, epithelialisation, complete healing, and adverse events. A systematic review of randomised controlled trials (RCTs) was performed across multiple databases, identifying five eligible studies involving 236 patients. Results indicated that enzymatic debridement was more effective, showing faster wound size reduction in four out of five studies, with Baloorkar et\u00a0al. reporting a 65% size reduction compared to 50% for autolytic debridement (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). Granulation tissue formation and epithelialisation rates were also significantly higher with enzymatic methods. Complete healing occurred in 65% of cases using enzymatic debridement versus 50% for autolytic methods (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.04). Mild irritation was the most common adverse event noted in the enzymatic group. In conclusion, enzymatic debridement proved to be superior for severe wounds, while autolytic debridement remains beneficial for less severe cases due to its non\u2010invasive nature. Both methods were well tolerated, but further research is needed for definitive clinical guidelines.\n                  <\/jats:p>","DOI":"10.1111\/iwj.70177","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T20:10:46Z","timestamp":1743451846000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Comparative Efficacy of Autolytic and Collagenase\u2010Based Enzymatic Debridement in Chronic Wound Healing: A Comprehensive Systematic Review"],"prefix":"10.1111","volume":"22","author":[{"given":"Ali","family":"Amadeh","sequence":"first","affiliation":[{"name":"Department of Nursing, School of Nursing and Midwifery Karaj Branch, Islamic Azad University  Karaj Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Negin","family":"Mohebbi","sequence":"additional","affiliation":[{"name":"Department of Nursing, School of Nursing and Midwifery Karaj Branch, Islamic Azad University  Karaj Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Amadeh","sequence":"additional","affiliation":[{"name":"Student Research Committee, faculty of Nursing and Midwifery Mashhad University of Medical Sciences  Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3904-3158","authenticated-orcid":false,"given":"Amirreza","family":"Jamshidbeigi","sequence":"additional","affiliation":[{"name":"Ghouchan School of Nursing, Mashhad University of Medical Sciences  Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0329-y"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","unstructured":"M.Bradley N.Cullum andT.Sheldon \u201cThe Debridement of Chronic Wounds: A Systematic Review.\u201dDatabase of Abstracts of Reviews of Effects (DARE): Quality\u2010Assessed Reviews [Internet] 1999 3.","DOI":"10.3310\/hta3171"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/WON.0b013e3181bfdf83"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2021.102876"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cnre.2017.03.003"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.7748\/ns.20.24.65.s58"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.10.002"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjon.2014.23.sup12.S10"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/00015458.2022.2068746"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12760"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2011.06.002"},{"key":"e_1_2_10_13_1","unstructured":"A. K.Pargi V.Pachole andR.Yadav \u201cTo Compare the Efficacy of Four Conventional and Contemporary Methods of Debridement Ie Surgical Autolytic Enzymatic and Mechanical in the Healing of Wounds of Various Etiology.\u201d2021."},{"key":"e_1_2_10_14_1","first-page":"372","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"71","author":"Page M. 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T.","year":"2010","journal-title":"Wounds"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.3111\/13696998.2013.807268"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.20517\/2347-9264.2018.46"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034509359125"},{"issue":"9","key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1111\/j.1610-0387.2012.07952.x","article-title":"Impact on Wound Healing and Efficacy of Various Leg Ulcer Debridement Techniques","volume":"10","author":"Doerler M.","year":"2012","journal-title":"Journal der Deutschen Dermatologischen Gesellschaft"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature07039"},{"issue":"1","key":"e_1_2_10_24_1","article-title":"Introducing Bromelain\u2010Based Enzymatic Debridement: There Is a Potential Paradigm Shift Towards Non\u2010surgical Wound Bed Preparation","volume":"42","author":"Snyder R. 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Randomized Double\u2010Blind Controlled Clinical Trial in Venous Leg Ulcers","volume":"21","author":"Scalise A.","year":"2017","journal-title":"European Review for Medical and Pharmacological Sciences"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijbiomac.2020.10.200"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.14308"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.70177","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T02:42:40Z","timestamp":1746412960000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.70177"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,30]]},"references-count":26,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1111\/iwj.70177"],"URL":"https:\/\/doi.org\/10.1111\/iwj.70177","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,30]]},"assertion":[{"value":"2024-10-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70177"}}