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Collagenase

Pronunciation: kohl-LAH-jen-ace
Class: Enzyme preparation

Trade Names

Collagenase Santyl
- Ointment 250 units of collagenase enzyme/g

Pharmacology

Contributes to the formation of granulation tissue and subsequent epithelialization of dermal ulcers and severely burned areas.

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Indications and Usage

Debriding chronic dermal ulcers and severely burned areas.

Contraindications

Standard considerations.

Dosage and Administration

Topical Once daily within the area of the wound; more often if dressing becomes soiled.

General Advice

  • For topical use only. Not for ophthalmic, oral, or intravaginal use.
  • May be applied directly to wound or to a sterile gauze pad, which is applied to the wound and secured.
  • To prevent irritation of surrounding healthy tissue, carefully apply ointment within wound area.
  • Prior to application, cleanse the wound of debris and digested material by gently rubbing with a gauze pad saturated with normal saline solution, or a collagenase-compatible cleansing agent (eg, hydrogen peroxide, Dakin solution), followed by a normal saline rinse.
  • Apply antibiotic powder, as ordered, to infected wound prior to application of collagenase ointment.

Storage/Stability

Store ointment at controlled room temperature not exceeding 77°F.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Miscellaneous

Hypersensitivity.

Precautions

Monitor

Application site

Monitor application site frequently during treatment. Inform health care provider if hypersensitivity reaction or local infection is noted or suspected.


Children

Safety and efficacy not established.

Debilitated patients

Closely monitor debilitated patients because risk of bacteremia may be increased.

Metal ions

Ensure antiseptics or soaks that are acidic or contain metal ions are not applied to wound because they decrease enzyme activity. If such materials have been applied to the wound, carefully cleanse the site with repeated washings with normal saline before applying collagenase ointment.

pH range

Optimal pH range for collagenase is 6 to 8; higher or lower pH conditions decrease collagenase activity.

Response to therapy

Ensure infected wound is being treated with topical antibiotic powder. If wound infection does not respond to topical antibiotic, be prepared to temporarily discontinue collagenase therapy until the infection has been controlled.

Patient Information

  • Advise patient or caregiver that ointment is used to help debride or remove dead tissue from ulcers or burned areas of the skin.
  • Teach patient or caregiver using ointment at home proper technique for applying ointment: Wash hands. Using sterile gloves, cleanse the wound of debris and digested material by gently rubbing with a gauze pad soaked with normal saline. Carefully apply ointment directly to the wound area, or to a sterile gauze pad, which is then secured with tape or gauze wrap. Wash hands after applying cream.
  • Advise patient or caregiver to apply ointment once daily unless dressing becomes soiled. Instruct patient to remove dressing if it becomes soiled and then reapply the ointment after cleansing the wound.
  • Instruct patient or caregiver not to use any cleansing solution or disinfectant other than that recommended by health care professional.
  • Caution patient or caregiver to avoid contact with the eyes. Advise patient or caregiver that if medication does come into contact with the eyes to wash the eyes with large amounts of cool water and to contact their health care provider if eye irritation occurs.
  • Advise patient or caregiver to report application site reactions (eg, rash, burning, stinging, itching) or suspected infection (eg, puss, unusual drainage).

Copyright © 2009 Wolters Kluwer Health.

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