Enzymatic Debridement Agents in 2026: Collagenase, Bromelain, and Hong Kong Availability

What qualifies as enzymatic debridement?

The classification should follow the active debriding mechanism. Collagenase qualifies because collagenase itself is the enzyme discussed in wound and ulcer debridement literature ^[2][4]. Bromelain-based preparations qualify because the reviewed chronic-wound and burn literature describes debridement using bromelain-enriched proteolytic enzymes ^[1][3].

That distinction matters because not every advanced wound product is an enzymatic debrider. Solventum’s Veraflo dressing materials describe hydromechanical removal of wound debris, exudate, infectious material, and non-viable tissue ^[5][6]. Those are debridement-adjacent wound-care functions, but the reviewed Veraflo materials do not identify an enzyme active ingredient ^[5][6].

Evidence snapshot: collagenase

Collagenase has the most direct chronic-wound relevance in this evidence set. A systematic review and meta-analysis examined collagenase for wounds and ulcers, screening 1,411 citations and including 22 studies that reported outcomes involving collagenase or a collagenase-containing product ^[2]. The review assessed wound healing, wound-bed characteristics, cost-effectiveness, and adverse events ^[2].

A wound-bed-preparation review also describes clostridial collagenase ointment as a form of enzymatic debridement that may assist both macroscopic and microscopic wound debridement during chronic application ^[4]. For a product notebook, this supports filing collagenase as an enzymatic debridement category, while still requiring local IFU, indication, compatibility, and supply checks before formulary use.

Product profile: Smith & Nephew Collagenase SANTYL

SANTYL is therefore best recorded as an enzymatic debridement candidate requiring Hong Kong verification, not as a confirmed locally available formulary item.

Evidence snapshot: bromelain-based debridement

Bromelain-based debridement has evidence signals in both chronic wounds and burns, but the practical notebook conclusion should remain cautious.

For chronic wounds, one source describes two consecutive single-arm studies in two medical centres designed to provide a first impression of safety and efficacy for a concentrate of proteolytic enzymes enriched in bromelain ^[1]. The same source reports no treatment-related serious adverse events and identifies pain as the only adverse event attributed to the enzymatic debridement ^[1]. Because the studies were preliminary, they support horizon scanning rather than automatic formulary substitution.

For burns, a review of seven clinical studies describes rapid and selective debridement using a bromelain-based debriding enzyme in deep partial-thickness and full-thickness burns ^[3]. Burn debridement, however, should be governed by specialist burn protocols rather than treated as interchangeable with routine chronic-wound dressing practice.

A newer venous-leg-ulcer signal also deserves attention. A 2025 post hoc analysis of the ChronEx trial reported bromelain-based enzymatic debridement data in venous leg ulcers, with 46 wounds treated with bromelain-based debridement and 8 treated with collagenase ointment ^[8]. That small collagenase comparator group makes the finding useful for evidence tracking, but not strong enough by itself to justify a formulary switch.

Brand-by-brand filing status

The absence of a verified product in this evidence set is not proof that a brand has no enzymatic product anywhere. It means the notebook should not treat the brand as confirmed until product-specific IFUs, local distributor details, and Hong Kong purchasing or formulary records are checked.

Minimum Hong Kong verification fields

Before adding any enzymatic debridement product to a hospital or clinic notebook, capture these fields:

1. Exact product name, manufacturer, and distributor.
2. Active enzyme and formulation, such as collagenase ointment or bromelain-based enzyme preparation.
3. Current IFU and jurisdiction-specific indication.
4. Hong Kong registration, purchasing, or formulary status.
5. Local supply continuity and substitution process.
6. Wound types supported by evidence, such as chronic ulcer, burn, or venous leg ulcer.
7. Contraindications, precautions, and compatibility instructions from the IFU.
8. Secondary dressing requirements and review frequency under local protocol.
9. Evidence level for the notebook entry, such as systematic review, clinical study, post hoc analysis, manufacturer page, or distributor document.

Bottom line

For a 2026 enterostomal therapy notebook, enzymatic debridement should be filed narrowly. The evidence reviewed here supports collagenase and bromelain-based preparations as the enzyme categories to track ^[1][2][3][4]. Smith & Nephew Collagenase SANTYL is the only clearly identified branded enzymatic product among the requested companies, but the cited product page does not confirm Hong Kong availability ^[12].

3M/Solventum Veraflo materials should be classified as hydromechanical, not enzymatic, based on the reviewed Solventum documents ^[5][6]. Other requested brands should remain in a supplier-evidence-required section until product-specific IFUs and Hong Kong access records are verified.