Researchers have confirmed the use of clostridial collagenase ointment in enzymatic debridement can help treat hard-to-heal diabetic foot ulcers.

The study evaluated the use of CCO in 215 diabetic patients over 12 weeks. All of them had neuropathic, nonischemic diabetic foot ulcers.

Patients were treated daily with a 2 mm layer of CCO or given a daily application of a hydrogel, with sharp debridement allowed in both groups when deemed necessary.

The wound area decreased relative to baseline for both groups after six and 12 weeks, with the CCO showing
a slightly better improvement closure (60% and 65% closed versus 50% and 51% for

Previous work has shown wound bed appearance of DFUs enzymatically debrided with CCO is indistinguishable from mechanical and serial sharp debridement, but the CCO ulcers have greater reductions in area.

While researchers noted surgical debridement remains the “gold standard,” some patients don’t tolerate it well. The study shows CCO can be a viable alternative for early treatment, with a lower incidence of infection, they said.