Motley TA, Caporusso JM, Lange DL, Eichelkraut RA, Cargill DI, Dickerson JE Jr, et al.
Advances in wound care. Date of publication 2018 Oct 1;volume 7(10):339-348.
1. Adv Wound Care (New Rochelle). 2018 Oct 1;7(10):339-348. doi:
10.1089/wound.2018.0784. Epub 2018 Oct 11.
Clinical Outcomes for Diabetic Foot Ulcers Treated with Clostridial Collagenase
Ointment or with a Product Containing Silver.
Motley TA(1), Caporusso JM(2), Lange DL(3), Eichelkraut RA(3), Cargill DI(3),
Dickerson JE Jr(4).
Author information:
(1)Department of Orthopedics, John Peter Smith Hospital and Acclaim Physician
Group, Fort Worth, Texas.
(2)Complete Family Footcare, McAllen, Texas.
(3)Smith & Nephew, Fort Worth, Texas.
(4)Graduate School of Biomedical Sciences, University of North Texas Health
Science Center, Fort Worth, Texas.
Objective: To compare outcomes of diabetic foot ulcers (DFUs) treated with
clostridial collagenase ointment (CCO) or silver-containing products, both in
combination with sharp debridement as needed. Approach: One hundred two subjects
with qualifying DFUs were randomized to daily treatment with either CCO or a
silver-containing product for 6 weeks followed by a 4 -week follow-up period. The
primary outcome was the mean percent reduction in DFU area. A secondary outcome
was the incidence of ulcer infections between groups. Results: At the end of
treatment, the mean percent reduction in area from baseline of DFUs treated with
CCO was 62% (p < 0.0001) and with silver was 40% (p < 0.0001). The difference
between groups-22%-was not statistically significant (p = 0.071). Among ulcers
closed by the end of treatment, the mean time to closure was 31.1 ± 9.0 days
versus 37.1 ± 7.7 days, respectively (not statistically significant). There was a
numerically greater incidence of target ulcer infections in the silver group (11,
21.6%) than in the CCO group (5, 9.8%; p = 0.208). No clinically relevant safety
signals were identified in either group. Innovation: CCO treatment can progress a
wound toward closure. Ulcer infection prophylaxis may not be sacrificed when
treating DFU with CCO in lieu of silver-containing products. Conclusion: Both CCO
and silver-containing products promote significant reduction in DFU area over 6
weeks of treatment with no clinically relevant safety concerns. Mean percent
reduction in lesion area was numerically (22%) but not significantly greater with
CCO compared to silver, as was time to ulcer closure, with an incidence of ulcer
infection at least as low as for silver-containing products.
DOI: 10.1089/wound.2018.0784
PMCID: PMC6203225
PMID: 30374419
