{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T20:43:12Z","timestamp":1765485792118},"reference-count":36,"publisher":"Mark Allen Group","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wound Care"],"published-print":{"date-parts":[[2006,5]]},"abstract":"Objective:<\/jats:title> A large retrospective analysis was performed to assess the outcomes of burns and chronic ulcers treated with collagenase in an outpatient setting. No cost comparison was performed. <\/jats:p><\/jats:sec>Method:<\/jats:title> Of 979 patients entered into the analysis, 647 had burns affecting \u226415% body surface area (BSA) and 332 had chronic ulcers of various aetiologies. All were treated with collagenase-based ointments once daily (Noruxol or Iruxol, Smith & Nephew). Treatment was continued until complete healing was achieved. <\/jats:p><\/jats:sec>Results:<\/jats:title> In burns patients the overall average healing time was 17.9 days in the paediatric population and 23.6 days in adults. Burn depth and presence of eschar were the main factors affecting healing probability. The chronic ulcers were predominantly of diabetic, venous and mixed aetiology. Average healing time was 15.4 weeks, with ulcers of mixed aetiology showing the shortest average healing time (9.2 weeks). There was a positive correlation between wound area and healing time. The topical application of collagenase-based ointments was well tolerated by patients and caregivers. <\/jats:p><\/jats:sec>Conclusion:<\/jats:title> This large retrospective analysis shows that collagenase treatments in outpatient clinics are effective and well accepted in patients with burns affecting \u226415% BSA or with chronic ulcers of various aetiologies. Implementation of collagenase treatments in outpatient clinics has the potential to improve wound healing and may also decrease the cost of wound care. <\/jats:p><\/jats:sec>Declaration of interest:<\/jats:title> The statistical evaluation was supported by Smith & Nephew. All materials were hospital acquired and the authors have no conflict of interest. <\/jats:p><\/jats:sec>","DOI":"10.12968\/jowc.2006.15.5.26910","type":"journal-article","created":{"date-parts":[[2014,5,23]],"date-time":"2014-05-23T15:59:18Z","timestamp":1400860758000},"page":"222-227","source":"Crossref","is-referenced-by-count":28,"title":["Effect of enzymatic debridement with collagenase on acute and chronic hard-to-heal wounds"],"prefix":"10.12968","volume":"15","author":[{"given":"M.","family":"Marazzi","sequence":"first","affiliation":[{"name":"Department of Tissue Therapy, Hard-To-Heal Ulcer Clinic; Head of the Regional (Lombardia region) Reference Centre for In Vitro Human Skin Culture and Human Tissue Bank, Niguarda Ca\u2019 Granda Hospital, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Stefani","sequence":"additional","affiliation":[{"name":"Department of Tissue Therapy, Hard-To-Heal Ulcer Clinic, Niguarda Ca\u2019 Granda Hospital, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Chiaratti","sequence":"additional","affiliation":[{"name":"Department of Tissue Therapy, Hard-To-Heal Ulcer Clinic, Niguarda Ca\u2019 Granda Hospital, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.N.","family":"Ordanini","sequence":"additional","affiliation":[{"name":"Department of Tissue Therapy, Hard-To-Heal Ulcer Clinic, Niguarda Ca\u2019 Granda Hospital, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Falcone","sequence":"additional","affiliation":[{"name":"Department of Tissue Therapy, Hard-To-Heal Ulcer Clinic, Niguarda Ca\u2019 Granda Hospital, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"Rapisarda","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Burn Centre, Niguarda Ca\u2019 Granda Hospital, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5130","reference":[{"key":"p_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7452.1366"},{"key":"p_2","volume-title":"Home safety: report summary. Burns and scalds accidents in the home. Department of Trade and Industry","author":"Department of Trade and Industry.","year":"1999"},{"key":"p_4","doi-asserted-by":"publisher","DOI":"10.1097\/01.SMJ.0000082011.70728.8C"},{"key":"p_5","doi-asserted-by":"publisher","DOI":"10.12968\/bjon.2000.9.Sup3.12483"},{"key":"p_6","volume-title":"ICSS. Proceedings of the ETRS society","author":"Harding K.","year":"2001"},{"key":"p_7","doi-asserted-by":"publisher","DOI":"10.1002\/0470846399.ch2"},{"key":"p_11","volume-title":"total, 631 patients (97.5%) were treated with Noruxol and 16 (2.5%) patients with Iruxol","author":"All"},{"key":"p_15","series-title":"Fig 2","volume-title":"deep seconddegree burns were always associated with woundbed necrosis and associated eschar. Healing rates in deep second-degree burns were slower than seen with superficial burns","author":"With"},{"key":"p_17","volume-title":"IDF","author":"International Diabetes Foundation","year":"2005"},{"key":"p_18","unstructured":"http:\/\/www.idf.org\/home\/ index.cfm?unode= F2E52CF1-7C7D-40D8-821B-46C9A815F086 (Accessed 12 July 2005)."},{"key":"p_20","doi-asserted-by":"publisher","DOI":"10.1046\/j.1524-475X.2003.11303.x"},{"key":"p_21","first-page":"849","volume":"73","author":"Barrett D.","year":"1973","journal-title":"Am J Nurs"},{"key":"p_22","volume-title":"Westerhof, W. (ed). Leg Ulcers: Diagnosis and Treatment.","author":"Hellgren L.","year":"1993"},{"key":"p_24","doi-asserted-by":"publisher","DOI":"10.1046\/j.1524-475X.11.s2.1.x"},{"key":"p_27","unstructured":"Principles of Surgery. McGraw-Hill, 1974."},{"key":"p_28","volume-title":"The clinical relevance of debridement","author":"Baharestani M.","year":"1999"},{"key":"p_31","doi-asserted-by":"publisher","DOI":"10.2165\/00044011-199815050-00002"},{"key":"p_33","doi-asserted-by":"publisher","DOI":"10.1097\/00004630-199505000-00004"},{"key":"p_34","first-page":"228","volume":"7","author":"Hansbrough J.F.","year":"1995","journal-title":"Wounds"},{"key":"p_36","volume-title":"Rev Bras Circ 1980"},{"key":"p_37","first-page":"1139","volume":"136","author":"Mekkes J.R","year":"2001","journal-title":"Pharm Weekly"},{"key":"p_39","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkh513"},{"key":"p_43","volume-title":"Overall mean healing time was faster in younger than older patients (18 days in patients under 15","author":"All"},{"key":"p_44","unstructured":"Factors that appeared to have the most influence on the probability of burn healing were the depth of the burn and the presence of eschar. After four weeks of collagenase treatment, superficial burns registered very high healing percentages (>90%) in the absence of eschar, and satisfactory healing (approximately 70-80%) in the presence of eschar. In the case of deep burns, eschar was almost always present, and at least four weeks of treatment were necessary to achieve a 50% healing rate among the patient population. Deep burns generally take longer to heal because they may be covered with deep layers of devitalised dermis, epidermis, wound secretions and eschar.15The formation of necrotic debris in these burn wounds frequently interferes with healing and potentially serves as a nidus for infection.14,15Clinical experience suggests that deep burns may be associated with a delay in healing, sometimes by up to two to three days.33"},{"key":"p_48","first-page":"150","volume":"22","author":"Mazurek I","year":"1971","journal-title":"Med Welt"},{"key":"p_49","first-page":"1","volume":"39","author":"Alfisi M.","year":"1984","journal-title":"Atti Accademia Medica Lombarda XXXIX"},{"key":"p_50","unstructured":"Berti. E. Activity of a collagenase CAF based preparation in the topical treatment of ulcers of the lower limbs of various types of aetiopathogenesis. G Ital Dermat Venereol 1980; 115: 9."},{"key":"p_51","first-page":"820","volume":"62","author":"Blum G","year":"1973","journal-title":"Schweiz Rundsch Med Praxis"},{"key":"p_53","first-page":"2","year":"1984","journal-title":"G Ital Angiol"},{"key":"p_54","first-page":"75","volume":"24","author":"Boxer A.M.","year":"1969","journal-title":"Geriatrics"},{"key":"p_55","first-page":"127","author":"Cariello V","year":"1981","journal-title":"Acta Gerontol"},{"key":"p_57","first-page":"53","volume":"13","year":"1977","journal-title":"Cardiovasc"},{"key":"p_58","unstructured":"De Luca, G. et al. Use of clostridiopeptidase A in combination with CAF in the treatment of paediatric burns. G I R 1987; 8: 64."},{"key":"p_59","first-page":"359","volume":"110","author":"Graifemberghi S.","year":"1984","journal-title":"Article in Italian. Clin Ter"},{"key":"p_60","first-page":"703","volume":"69","author":"Helaly P.","year":"1980","journal-title":"Praxis"},{"key":"p_62","volume-title":"Collagenase in the treatment of torpid ulcerative lesions of the lower limbs. 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