Proteolysis in Wound Repair

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Extracellular matrix (ECM) turnover is a complex process that remains incompletely understood. Numerous studies aim to uncover the mechanisms that produce and maintain ECM in tissues, with wound repair in animals serving as a valuable tool for exploration. During this pathological event, the components of the healing system are exaggerated, allowing for clearer observation. It is now recognized that regulating protease/inhibitor activity is crucial for maintaining ECM integrity in both normal and pathological states. Failures in this regulation can lead to abnormal wound healing, ranging from nonhealing wounds to hypertrophic scarring. Recent experimental findings have been applied in clinical practice, highlighting the significance of debridement in normal and poorly healing wounds. Various methods have been proposed to create an optimal wound bed for skin transplantation, with mechanical and physical debridement procedures offering advantages, especially for extensive third-degree burns. However, these methods can also lead to pain, excessive blood loss, and indiscriminate debridement. Consequently, many enzymatic formulations have been developed and utilized by clinicians worldwide to address these challenges.