Jwc ewma final indd

J O U R N A L  O F WO U N D  C A R E   Vo l   2 2 .  N o   1 .  E W M A   D o c u M E N t   2 0 1 3

origin

Enzyme

Source

Animal

Fibrinolysin

Bovineplasma

Desoxyribonuclease

Bovinespancreas

Krillmultienzymecomplex

Antarctickrill

Collagenase

Paralithodescamtschatica

Catalase

Equineliver

Plant

Papain

Caricapapaya

Bromelainenzymecomplex

Pineapple

Bacteria

Collagenase

Clostridium histolyticum

Streptokinase

Streptococcus haemolyticus

Streptodornase

Streptococcus haemolyticus

Sutilain

Bacillus subtilis

Table3.Proteolyticenzymesforwoundtreatment

34

Necrotic tissue consists of cellular debris embedded 

in an extracellular matrix (ECM), mainly 

consisting of type IV collagen, glycoproteins 

and proteoglycans. These components are 

released by the activity of collagenases and can 

subsequently be degraded by macrophages and 

other proteases. The resulting collagen fragments 

stimulate additional fibroblasts and macrophages 

and thus induce chemotactic effects. Collagen 

also comprises 70–80% of the dry weight of the 

skin and is the primary constituent of the human 

dermis; therefore, it forms a substantial component 

of the non-viable tissue.

In contrast to the collagenases of mammals, bacterial 

collagenase breaks the triple helix structure of 

various collagens at multiple points, thus generating 

smaller peptides that induce forced further 

degradation of the collagen. Bacterial collagenase 

promotes wound healing by digesting native 

collagen bundles that bind non-viable tissue to the 

wound surface and by dissolving collagenic debris 

within the wound. The most commonly used wound 

products contain the collagenase Clostridiopeptidase 

A from Clostridium histolyticum.

52–54

Streptokinase is a fibrin-degrading kinase 

with a preferred point of attack between 

arginine–valine bonds. The streptokinase catalyses 

the generation of plasmin from plasminogen. 

Plasmin degrades fibrin, fibrinogen, factor V 

and VIII into polypeptides and amino acids. In 

addition, plasmin forms a complex with human 

plasminogen, leading to a conformational change 

of plasminogen, exposing its active centre. The 

result is a streptokinase-plasminogen complex 

that can activate plasminogen. Therefore, 

streptokinase’s effects require the presence of a 

plasminogen-containing wound environment.

Streptodornase is a deoxyribonuclease 

(DNAse) with endonucleolytic activity against 

double-stranded DNA. Streptodornase will 

contribute a complex with free plasminogen, 

which catalyses the conversion of plasminogen 

to plasmin. It liquefies the viscous nucleoprotein 

of dead cells or pus and has no effect on living 

cells. Similarly, coagulated blood can be liquefied 

and then be absorbed. By these characteristics, 

the streptodornase is particularly suitable when 

used in combination with other enzymes, such as 

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