Milne CT, Ciccarelli AO, Lassy M, et al.
Wounds : a compendium of clinical research and practice. Date of publication 2010 Nov 1;volume 22(11):270-4.
1. Wounds. 2010 Nov;22(11):270-4.
A comparison of collagenase to hydrogel dressings in wound debridement.
Milne CT(1), Ciccarelli AO(2), Lassy M.
Author information:
(1)Connecticut Clinical Nursing Associates, LLC and Bristol Hospital Wound,
Ostomy, Lymphedema Center, Bristol, Connecticut; Email: ccna2@juno.com.
(2)
Comparisons of collagenase to other methods of debridement, including wet
to dry dressings, have been reported in the literature; however, studies
comparing collagenase to hydrogel have not been reported.OBJECTIVE: Time to
complete necrotic tissue debridement with collagenase compared to hydrogel in
institutionalized adults with pressure ulcers.
METHODS: Randomization occurred after obtaining informed consent to avoid
selection bias. Subjects received daily dressing changes with either hydrogel or
collagenase followed by a standard semi-occlusive dressing to evaluate time to
debridement up to Day 42. Investigators, who were blinded to randomization,
evaluated weekly wound photographs for necrotic tissue debridement and wound
healing parameters using a digital planimetry software package. Nonviable tissue
was not cross-hatched in either group.
RESULTS: Twenty-seven nursing home residents were enrolled over a period of 1
year. According to a Student's t test, there were no significant differences
between groups for age, gender, age of wound, or percentage of nonviable tissue
at the time of enrollment (P = .03). Using a Pearson Chi square analysis, the
collagenase group was found to have statistical (P = .003) significance in
achieving full debridement by Day 42.
CONCLUSION: This study showed statistical significance in favor of collagenase
when used to debride nonviable tissue in pressure ulcers. Despite recommendations
to cross-hatch eschar, statistical significance was still achieved when wounds
were not cross-hatched, indicating clinical utility in settings without clinician
availability for the cross-hatching procedure.
PMID: 25901516
