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Laboratory Research
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A silicone based controlled release dressing for accelerated proteolytic debridement Lillian B. Nanney, Jeffrey M. Davidson, James W. Crissman, Paal C. Klykken, Xavier Thomas, Gregory S. Whitaker, Thomas H. Lane, Kurt F. Bradstadt, Csilla Killar, Mae Saldajeno, Grant Ganshaw, Mark Gebert, Isabelle Mazeaud, Richard Bott A unique dressing for rapid enzymatic debridement has been developed using a controlled release silicone emulsion. This emulsion incorporates a protease in a dehydrated state that shows excellent performance in accelerated stability tests, with retention of ~90% of the initial activity for an equivalent of 18 months storage at room temperature. Moisture from the host provides the trigger for a reproducible release of the enzyme from the emulsion, with complete release of the enzyme within the first eight hours. The enzyme is a serine protease of the subtilisin family that has not been tested previously as a debriding enzyme. The silicone delivery device acts synergistically with the enzyme to promote rapid debridement together with a moist wound environment. This property allows the device to achieve essentially complete removal of hardened eschar from full thickness porcine burns after a single exposure period of 24 hours. The study involved various dosage levels and was benchmarked against both an existing enzymatic debridement product and no treatment. It demonstrated a clear dose response. In addition to high efficiency, no histological evidence of damage to healthy tissue was observed. The events of wound repair followed normal healing patterns after this treatment, while the more rapid debridement allowed faster progression into the healing phase when compared to the benchmarks. With the dramatic improvement in the speed of wound debridement it is possible to accelerate the total wound healing episode while at the same time reducing the potential for complications and reducing the amount of skilled care required for the debridement phase Support provided by NIH, Dept of Veterans Affairs, Dow Corning, Genencor |
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