Healing of infected wounds treated with human plasmin and hyaluronidase; débridement and healing of infected wounds, several with metallic foreign bodies.

Abstract

Enzyme therapy of infected wounds and ulcerating lesions is a rapidly developing field, in which there is great promise. It is said that John Hunter used crude pancreatic enzymes in the treatment of wounds. The maggot treatment of dirty chronic infected wounds and osteomyelitis cavities was undoubtedly effective because of proteolytic enzymes secreted by the maggots. 1 The modern methods of enzyme treatment using purified materials have been developed only in recent years. 2 Papain 3 was used as long ago as the First World War for cleansing of infected burns and dirty wounds but was abandoned because of the severe irritation it caused. It was with streptokinase and streptodornase 4 that the first well-controlled studies of this type of therapy were made. 5-8 Trypsin, a proteolytic enzyme obtained from the pancreas, is a stronger digestive enzyme, which has been used with success in debridement. 9-11 Bovine plasmin (fibrinolysin) has