Class: Enzymatic Debridement Agents

Agent(s) Common Uses Contraindications Route Onset of Action Interactions

Collagenase (Santyl) Wound debridement Known local OIntment Skin products containing
or systemic heavy metals may
hypersensitivity to decrease the effect of
collagenase. collagenase.

Mechanism of Action

An enzymatic debriding agent capable of specifically hydrolyzing peptide bonds of collagen.

Liquefies necrotic tissue without damaging granulation tissue.
Advantages/Disadvantages
Side Effects Adverse Effects

Slight erythema may develop in Bacterial infection.

surrounding tissue
Possible risk of systemic bacterial
infection

Nursing Interventions Client Education

Prior to each application, cleanse wound with a gauze pad saturated Do not apply to healthy skin.
with 0.9% sodium chloride solution or a compatible cleansing agent Notify primary healthcare provider of any symptoms of serious
to remove necrotic material and follow with a normal saline solution infection (fever, chills, hyperventilation, tachycardia)
rinse.

Use caution to restrict application to the lesion; avoid applying to

healthy skin.

Do not apply to internal cavities.

References: Kee, J. L., Hayes, E. R., McCuistion, L. E. (2015). Pharmacology: A patient-centered nursing process approach (8th ed.). Elsevier Saunders.

Skidmore-Roth, L. (2016). Mosby’s 2016 nursing drug reference (29th ed.). Elsevier: St. Louis
Class: Topical Anti-infectives
Agent(s) Common Uses Contraindications Route Onset of Action Interactions
Silver sulfadiazine Prevention and Hypersensitivity Topical 2-4- hours
(Silvadene) treatment Pregnancy
of wound sepsis in
Mafenide acetate Newborns
patients with second-
(Sulfamylon)
and third-degree
Silver nitrate burns.
Povidone-Iodine (Betadine)

Mechanism of Action

Interferes with bacterial protein synthesis.

Advantages/Disadvantages
Side Effects Adverse Effects

Skin discoloration Transient leukopenia

Burning sensation Skin necrosis
Rash Interstitial nephritis.

Nursing Interventions Client Education

Check for allergy to sulfa antibiotics. Cover wound completely with ointment.
Check for iodine allergy with use of povidone-iodine.

References: Kee, J. L., Hayes, E. R., McCuistion, L. E. (2015). Pharmacology: A patient-centered nursing process approach (8th ed.). Elsevier Saunders.

Skidmore-Roth, L. (2016). Mosby’s 2016 nursing drug reference (29th ed.). Elsevier: St. Louis