Drug Guide
Collagenase (Santyl)
Classification
Therapeutic: Wound debridement agent
Pharmacological: Enzyme (collagenase)
FDA Approved Indications
- Removal of necrotic tissue in pressure ulcers, diabetic foot ulcers, and full-thickness burns
Mechanism of Action
Collagenase enzymatically breaks down collagen in necrotic tissue, facilitating debridement and promoting wound healing.
Dosage and Administration
Adult: Apply liberally to the wound bed once daily, covering with a sterile dressing.
Pediatric: Dosing based on wound size and clinical judgment; consult specific product guidelines.
Geriatric: Same as adult; monitor for skin sensitivity.
Renal Impairment: No specific adjustment; caution advised.
Hepatic Impairment: No specific data; caution recommended.
Pharmacokinetics
Absorption: Not absorbed systemically when applied to skin.
Distribution: Localized at site of application.
Metabolism: Degraded locally by tissue proteases.
Excretion: Not systemically excreted.
Half Life: Not applicable (local application).
Contraindications
- Known hypersensitivity to collagenase or other components.
- Presence of healthy, intact skin at the wound site.
Precautions
- Use with caution in wounds with exposed blood vessels, nerves, or organs.
- Avoid use on wounds with active infection unless directed by a healthcare professional.
Adverse Reactions - Common
- Local skin irritation (Uncommon)
Adverse Reactions - Serious
- Allergic contact dermatitis (Rare)
- Excessive tissue destruction leading to bleeding or damage (Rare)
Drug-Drug Interactions
- None specific; caution if using other topical agents that may interfere with collagenase activity.
Drug-Food Interactions
- None
Drug-Herb Interactions
- None
Nursing Implications
Assessment: Assess wound type, size, and necrosis extent.
Diagnoses:
- Impaired tissue integrity
- Risk for infection
Implementation: Apply as directed, ensure wound is properly cleaned before application, and cover with appropriate dressing.
Evaluation: Monitor for signs of infection, wound healing progress, and adverse reactions.
Patient/Family Teaching
- Keep wound area clean and dry.
- Follow dressing change instructions carefully.
- Report signs of infection, unusual pain, or allergic reactions.
Special Considerations
Black Box Warnings:
- None
Genetic Factors: None identified.
Lab Test Interference: None expected.
Overdose Management
Signs/Symptoms: Local tissue damage or bleeding if over-application occurs.
Treatment: Discontinue use, support wound care, and consult healthcare professional for further management.
Storage and Handling
Storage: Store at room temperature, away from light and moisture.
Stability: Stable until expiration date on package.