Enzymatic Debriding Agent
Pregnancy: C
Collagenase (Wound Debridement)
Brand names: Santyl, Iruxol Mono
Adult dose
Dose: Apply once daily to wound bed after cleansing; cover with moist dressing
Route: topical
Frequency: once daily
Max: Topical use only
Clostridium histolyticum collagenase — selectively digests collagen in necrotic tissue; preserve surrounding healthy tissue; discontinue when wound clean
Paediatric dose
Route: topical
Frequency: once daily
Concentration: 250 units/g ointment /ml
Limited paediatric data; used in specialist burns/wound care settings for debridement; same principles as adults
Dose adjustments
Renal
Not applicable (topical)
Hepatic
Not applicable
Clinical pearls
- Do NOT use with silver-containing dressings or antiseptics — inactivates the enzyme
- Iruxol Mono preferred over Iruxol (no neomycin — lower sensitisation risk)
- Best evidence for partial thickness burns and pressure ulcers — promotes healing by removing necrotic tissue without damaging granulation tissue
Contraindications
- Hypersensitivity to collagenase or Clostridium components
Side effects
- Local pain/burning on application
- Contact dermatitis
- Potential for increased wound exudate
Interactions
- Heavy metal ions (mercury, silver — inactivate enzyme)
- Hydrogen peroxide (inactivates collagenase)
- Povidone-iodine (inactivates enzyme — do NOT use concurrently)
Monitoring
- Wound healing progress
- Signs of local hypersensitivity
- Wound bed preparation assessment
Reference: BNFc; BNF 86; BBA wound care guidelines; Wounds UK best practice. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.