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Accuzyme® is a white, creamy ointment used for debridement, or the removal of necrotic — or dead — tissue. This is done to improve the healing process of the healthy tissue the body is able to retain. Accuzyme® usually comes in a 6- or 30-gram tube, though some manufacturers have made the medicine in spray form.
Accuzyme® is hydrophillic, which means it is attracted to and can easily dissolve in water. It contains papain, an enzyme that can be found in papaya fruits. Papain, the key ingredient in Accuzyme®, has been used for centuries as a meat tenderizer, because it destroys the tough bands between fibers that bind together muscle tissue.
Patients are recommended to apply Accuzyme® on the affected areas once or twice a day and cover appropriately with bandages. The wounds should be cleaned with each application to get rid of the accumulation of liquefied dead tissue. The debriding process starts when the papain enzyme combines with urea, an organic compound produced by the wound moisture. Urea is an activator of papain's digestive power, which is relatively mild when used alone.
Aside from debridement of necrotic tissue, Accuzyme® is used for liquefying pus in acute and chronic lesions. This includes pressure, varicose and diabetic ulcers; and post-operative, traumatic and infected wounds. Accuzyme® can also be used for carbuncles, which is a contagious bacterial infection, and pilonidal cysts, which are wounds with hair debris that appear in the cleft between the buttocks.
Some serious side effects are associated with the use of Accuzyme®. Some patients have reported allergic, hypersensitive reactions to the papain, which led to hypotension — a medical condition also known as low blood pressure. Another major adverse event is the occurrence of tachycardia, which means some patients experience an increase in their heart rates. Moreover, patients who are allergic to latex are usually allergic to papaya, as well, thus increasing their risk of suffering such side effects.
As a result of the possibility of such severe side effects, Accuzyme® is not approved by the U.S. Food and Drug Administration (FDA) for sale in the United States. In September 2008, the FDA included the ointment on the list of unapproved topical drug products containing papain that should no longer be manufactured by 24 November 2008 and shipped by 21 January 2009. Companies that continue to manufacture and market Accuzyme® after the aforementioned dates face the risk of FDA enforcement action, which includes injunction or seizure of products.