Gilligan AM, Waycaster CR, Bizier R, Chu BC, Carter MJ, Fife CE, et al.
Advances in wound care. Date of publication 2017 Apr 1;volume 6(4):125-134.
1. Adv Wound Care (New Rochelle). 2017 Apr 1;6(4):125-134. doi:
10.1089/wound.2016.0720.
Comparative Effectiveness of Clostridial Collagenase Ointment to Medicinal Honey
for Treatment of Pressure Ulcers.
Gilligan AM(1), Waycaster CR(2), Bizier R(3), Chu BC(4), Carter MJ(5), Fife
CE(6).
Author information:
(1)Truven Health Analytics, Houston, Texas.
(2)Smith & Nephew, Fort Worth, Texas.
(3)Truven Health Analytics, Cambridge, Massachusetts.
(4)Truven Health Analytics, Santa Barbara, California.
(5)Strategic Solutions Inc., Cody, Wyoming.
(6)Intellicure, Inc, The Woodlands, Texas.
Objective: Compare enzymatic debridement using clostridial collagenase ointment
(CCO) with autolytic debridement using medicinal honey in the hospital outpatient
setting for treating pressure ulcers (PUs). Approach: Retrospective deidentified
electronic health records from 2007-2013 were extracted from the U.S. Wound
Registry. Propensity score matching followed by multivariable analyses was used
to adjust for selection bias and assess treatment effects comparing CCO-treated
versus honey-treated PUs. Key outcomes included 100% granulation and
epithelialization at 1 year. Results: Five hundred seventeen CCO-treated PUs (446
patients) were matched to corresponding honey-treated PUs (341 patients). The
majority of PUs were stage III (CCO 56%, honey 55%). CCO users had significantly
fewer total visits (9.1 vs. 12.6; p < 0.001), fewer total selective sharp
debridements (2.7 vs. 4.4; p < 0.001), and fewer PUs receiving negative pressure
wound therapy (29% vs. 38%; p = 0.002) compared with honey. Innovation:
CCO-treated PUs were 38% more likely to achieve 100% granulation compared to
honey-treated PUs at 1 year, p = 0.018. Mean days to 100% granulation were
significantly lower for CCO-treated PUs (255 vs. 282 days, p < 0.001).
CCO-treated PUs were 47% (p = 0.024) more likely to epithelialize at 1 year
compared to PUs treated with honey. Mean days to epithelialization were
significantly lower for PUs treated with CCO at 1 year (288 vs. 308 days;
p = 0.011). Conclusion: All stages of PUs treated with CCO achieved faster rates
of granulation and subsequent epithelialization compared to PUs treated with
medicinal honey as measured by real-world data collected in the hospital
outpatient department care setting.
DOI: 10.1089/wound.2016.0720
PMCID: PMC5385575
PMID: 28451469
