Ask the treatment expert

Is it true that all topical wound products containing papain are being discontinued?

Yes, the U.S. Food and Drug Administration (FDA) has ordered companies to stop marketing and manufacturing all topical drug products that contain papain by Nov. 24, 2008. Papain, an enzyme from the fruit of Carica papaya, is an ingredient found in several topical debriding ointments. Some popular ointments affected by this ruling include Accuzyme, Allanfil, AllanZyme, Ethezyme, Gladase, Kovia and Panafil.

The FDA decision against these products is due to reports of serious adverse events in patients using products containing papain. The FDA report also mentions that the effectiveness of these products is not supported by scientifically sound studies in the medical literature.

Companies or others engaged in shipping topical papain products must stop shipping by Jan. 21, 2009.  For more information visit: http://www.fda.gov/cder/news/papain/qa.htm

What are some topical treatment options for wound debridement without papain?

Collagenase Santyl is an ointment that can be used for topical debridement of necrotic tissue in dermal and burn wounds. Another option for topical debridement includes using wound dressings that promote autolytic debridement.

The key is keeping the wound moist, which can be accomplished with a variety of dressings.