How do you effectively treat non-healing wounds in patients with diabetes?

Collagenase preparations have been used in the treatment of non-healing wounds in diabetic patients, particularly in the context of diabetic foot ulcers. Collagenase is an enzyme that breaks down collagen, which is a major component of the extracellular matrix in wounds. By degrading the collagen, collagenase can help remove devitalized tissue, promote wound bed preparation, and facilitate the healing process.
The effectiveness of collagenase preparations in diabetic wound care has been evaluated in various clinical studies and systematic reviews. Overall, the evidence suggests that collagenase can be beneficial in certain cases, although individual responses may vary.
One randomized controlled trial published in 2013 compared the use of collagenase with a placebo in patients with diabetic foot ulcers. The study found that collagenase treatment resulted in a higher proportion of wounds achieving complete closure compared to the placebo group. Additionally, collagenase was associated with a shorter time to complete wound closure.
Another systematic review and meta-analysis published in 2018 examined the use of collagenase in diabetic foot ulcers specifically. The analysis included several randomized controlled trials and concluded that collagenase was effective in promoting wound healing and reducing the time to healing. The review also noted that collagenase appeared to be safe and well-tolerated.
It's important to note that collagenase preparations are typically used in conjunction with standard wound care practices, such as regular wound cleansing, appropriate dressings, offloading pressure from the wound, and managing underlying factors like blood glucose control. The exact protocol and treatment duration may vary depending on the individual patient and wound characteristics.