OBJECTIVES: Identify patient and clinical characteristics in the diabetic foot ulcer (DFU) population and examine patterns of enzymatic debridement utilization. METHODS: Retrospective, de-identified electronic medical records from 2007-2013 were extracted from the Intellicure Limited Data Set (I-LDS). The I-LDS extracts records from 96 hospital-based outpatient wound centers. Patient, wound and encounter level characteristics were examined. The treatment of interest was enzymatic debridement with clostridial collagenase ointment (CCO).    RESULTS: A total of 10,359 patients, 21,677 wounds, and 222,861 encounters for DFU were identified. The majority of patients was male (60.9%), Caucasian (63.5%), and reported Medicare as their primary insurance (51.1%). Of the 21,677 wounds, approximately 16.9% received CCO (n=3,670). Overall, the mean wound surface area was significantly larger (p<0.0001) in DFUs treated with CCO (7.6cm) compared to wounds not treated with CCO (5.4cm), respectively. Wounds treated with CCO had significantly more (p<0.001) debridements of all methods (5.4, SD=6.3) relative to the overall population (4.3, SD=6.1). Problems treated with CCO were significantly more likely (p<0.0001) to have an infection (63.4%) compared to the overall DFU population (50.9%). The average number of visits where CCO was administered was 10.2 (SD=9.7) and the average days of use with CCO was 53.2 days (SD=68.9). The average number of CCO tubes used by patients was 2.4 (SD=0.9). Mean days in service for CCO-treated wounds was 129.5 (SD=149.1), which was significantly higher compared to days in service for non-CCO treated wounds (102.6, SD=151.8).     CONCLUSIONS: Wounds treated with CCO were larger, more likely to receive debridement of all methods, and more likely to be infected relative to the overall DFU population. Results from this analysis indicate that health care providers are using CCO in more severe, difficult-to-heal DFUs.