do you know anything about santyl ointment?
thanks,
larry

Greetings Larry,

Santyl ointment is a petroleum based product containing collagenase that is formulated to debride (remove) necrotic (dead) tissue cells from burns, ulcers, gangrenous tissue and poorly healing wounds.   Much like maggots  were once (and currently on occasion still are) applied to selectively remove the dead tissue of a poorly responding wound to promote healing, the collagenase of santyl ointment is also used for this specific purpose.

I suppose it is because of the way this collagenase ointment is formulated that it is to be applied specifically only to dead tissue, and not healthy or living tissue.  This makes its use for Dupuytren treatment contraindicated, and is likely the reason it does not have FDA approval for Dupuytren use.  This is probably also the reason that the drug manufacturers have not attempted to market it as a Dupuytren disease treatment.

When it is applied carelessly or accidentally to normal tissue a reaction occurs in which localized inflammation develops, suggesting that the collagen of normal tissue is attacked by the collagenase of santyl ointment.   Given the nature of collagenase to indiscriminately disrupt collagen, prolonged use for Dupuytren cord or nodule treatment would result eventually result in an ulcer that would not heal because of the presence of collagenase.  For this reason the manufacturer of santyl ointment is careful to emphasize that it should only be applied to the dead tissue of a burn, ulcer, gangrene or poorly healing wound, not intact and viable skin.

Lastly, I have have checked the molecular weight of collagenase and I believe it is too large for it to be carried by DMSO through the tissue. TRH