From the Guidelines
The active ingredient of Santyl is collagenase, specifically collagenase derived from Clostridium histolyticum. Santyl is a prescription enzymatic debriding ointment used primarily for wound care. It works by breaking down collagen in necrotic tissue within wounds, which helps remove dead tissue and promote healing of healthy tissue. This selective action on denatured collagen allows Santyl to debride wounds without harming healthy tissue. According to the study 1, the use of clostridial collagenase ointment (CCO) has been examined in five RCTs, all of which were unblinded, and the results suggest that it can be effective in debriding wounds.
Some key points to consider when using Santyl include:
- Applying the ointment directly to the wound at a thickness of approximately 1/16 inch and covering it with an appropriate dressing
- Avoiding the use of certain antiseptics, heavy metal ions, detergents, or other enzymes that may decrease its effectiveness
- Gently cleansing the wound before each application
- Continuing treatment until the wound is free of necrotic tissue. The study 2 also mentions the importance of debridement in wound care, although it does not specifically discuss Santyl, it highlights the need for effective debridement methods to promote healing.
It's worth noting that while the evidence from 2 and 1 provides some insight into the use of debridement and collagenase ointment, the quality of the evidence is not always strong, and more research may be needed to fully understand the effectiveness of Santyl. However, based on the available evidence, collagenase derived from Clostridium histolyticum is the active ingredient in Santyl, and it can be a useful tool in wound care.
From the FDA Drug Label
Collagenase Santyl◊ Ointment is a sterile enzymatic debriding ointment which contains 250 collagenase units per gram of white petrolatum USP. The enzyme collagenase is derived from the fermentation by Clostridium histolyticum.
The active ingredient of Santyl is collagenase, an enzyme derived from the fermentation by Clostridium histolyticum 3.
From the Research
Active Ingredient of Santyl
- The active ingredient of Santyl is Clostridial collagenase, which is a highly-purified enzyme that selectively and painlessly degrades devitalized tissue 4, 5.
- Clostridial collagenase is also referred to as CS-API, which is the active pharmaceutical ingredient in Collagenase Santyl Ointment (CSO) 5.
- The enzyme works by breaking down collagenous materials in necrotic tissues, achieving selective debridement and digesting denatured collagen in eschar while sparing nonnecrotic tissues 6.
Mechanism of Action
- The active ingredient of Santyl, CS-API, induces the expression of mϕheal /M(IL-4) polarization markers ex vivo, which contributes to the resolution of persistent wound inflammation 5.
- CS-API treatment attenuates transactivation of NF-κB and significantly induces STAT6 phosphorylation, leading to a significant role of a novel PGE2-EP4 pathway in CS-API induced STAT6 activation and the mϕheal /M(IL-4) polarization 5.