Enzymatic Debriding Agent

Collagenase (Wound Debridement)

Brand names: Santyl, Iruxol Mono

A topical enzymatic debriding agent derived from Clostridium histolyticum used to remove devitalised tissue from chronic wounds and burns.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Apply the ointment once daily to the wound (no unit dose stated in the label); apply directly to the wound or to a sterile gauze pad which is then applied to the wound and properly secured

Route: Topical (to the wound bed)

Frequency: Once daily, or more frequently if the dressing becomes soiled (e.g. from incontinence)

No UK SPC was retrieved for this product — dose is taken from the US FDA label for COLLAGENASE SANTYL Ointment (Smith & Nephew, label date 2019-05-17) and must be checked against the UK SPC of the product actually in use. Label method: (1) before application cleanse the wound of debris and digested material by gently rubbing with a gauze pad saturated with normal saline solution, or with a compatible cleansing agent, followed by a normal saline rinse; (2) when clinically indicated, crosshatching thick eschar with a #10 blade allows more surface contact with necrotic debris, and it is desirable to remove as much loosened detritus as can readily be done with forceps and scissors; (3) whenever infection is present it is desirable to use an appropriate topical antibiotic powder, applied to the wound BEFORE the ointment — if the infection does not respond, discontinue the ointment until remission of the infection; (4) terminate use when debridement of necrotic tissue is complete and granulation tissue is well established.

Dose auto-extracted from US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Patients who have shown local or systemic hypersensitivity to collagenase

Side effects

No allergic sensitivity or toxic reactions have been noted in clinical use when used as directed (per label)
One reported case of systemic manifestations of hypersensitivity to collagenase in a patient treated for more than one year with a combination of collagenase and cortisone

Clinical monograph

How it works

Collagenase digests denatured collagen anchoring necrotic tissue to the wound bed, achieving selective enzymatic debridement while sparing viable tissue.

Prescribing in practice

Its enzymatic activity is inactivated by certain heavy-metal antiseptics and acidic agents, so incompatible cleansers and dressings must be avoided around application.
It is intended for debridement and does not treat established wound infection, which needs separate management.
Transient local discomfort or erythema at the wound margin can occur.

Monitoring

Monitor the wound bed at dressing changes for progress of debridement, granulation and any peri-wound irritation or infection.

Counselling the patient

This ointment helps remove dead tissue so the wound can heal.
Some surrounding redness or mild discomfort can occur.
Use only the cleansing products advised, as some can stop it working.

Evidence & guidelines

Enzymatic debridement with collagenase is an established alternative to sharp or autolytic debridement in chronic-wound and burn care.

Reference: BBA wound care guidelines; Wounds UK best practice; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators