| Plant origin |
Papain |
1940 |
Glasser |
Carica papaya
|
Strong debriding effect |
Activator substance needed (e.g., triethanolamine) |
| Plant origin |
Ficin/Debricin |
1949 |
Connel |
Ficus carica
|
Rapid debriding effect |
Lack of standardization |
| Plant origin |
Bromelain |
1957;1985 |
Heinicke, Klein |
Ananas comosus
|
Fastest debriding effect, high level of standardization approval as a medical product (NexoBrid™) |
Expensive treatment standard use only in burn centers due to the learning curve |
| Bacterial origin |
Clostridial collagenase ointment/CCO/Santyl |
1951 |
Altemeier |
Clostridium histolyticum
|
Effective debridement of human eschar |
Lack of randomized trials |
| Bacterial origin |
Streptokinase/Streptodornase/Varidase |
1952;1957 |
Teitelman, Connel |
Hemolytic streptococci |
- |
Insufficient debridement of full-thickness burns |
| Bacterial origin |
Sutilains/Travase |
1969 |
Garett |
Bacillus subtilis
|
Wound closure by autologous skin grafting is achieved faster than that with SOC approval as a medical product in the US |
Increase in wound infections when used time consuming therapy (full debridement within 24 h) |
