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Comparative Effectiveness of Clostridial Collagenase Ointment to Medicinal Honey for Treatment of Pressure Ulcers

View Article: PubMed Central - PubMed

ABSTRACT

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.

No MeSH data available.


Probability of 100% granulation over 365 days (Kaplan–Meier curve).
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f1: Probability of 100% granulation over 365 days (Kaplan–Meier curve).

Mentions: The Cox regression found that CCO-treated PUs had a 30% significantly higher probability of achieving 100% granulation compared to honey-treated PUs, with a HR of 1.302 (95% CL 1.056–1.605, p = 0.013). CCO-treated PUs achieved 100% granulation within a significantly shorter mean (SD) time frame compared to honey (CCO 255.3 [129.8] days, honey 282.2 [127.4] days; p < 0.001) (Table 5). Figure 1 graphically shows the probability of achieving 100% granulation during the 1-year follow-up, comparing CCO and honey cohorts.


Comparative Effectiveness of Clostridial Collagenase Ointment to Medicinal Honey for Treatment of Pressure Ulcers
Probability of 100% granulation over 365 days (Kaplan–Meier curve).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5385575&req=5

f1: Probability of 100% granulation over 365 days (Kaplan–Meier curve).
Mentions: The Cox regression found that CCO-treated PUs had a 30% significantly higher probability of achieving 100% granulation compared to honey-treated PUs, with a HR of 1.302 (95% CL 1.056–1.605, p = 0.013). CCO-treated PUs achieved 100% granulation within a significantly shorter mean (SD) time frame compared to honey (CCO 255.3 [129.8] days, honey 282.2 [127.4] days; p < 0.001) (Table 5). Figure 1 graphically shows the probability of achieving 100% granulation during the 1-year follow-up, comparing CCO and honey cohorts.

View Article: PubMed Central - PubMed

ABSTRACT

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&ndash;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&thinsp;&lt;&thinsp;0.001), fewer total selective sharp debridements (2.7 vs. 4.4; p&thinsp;&lt;&thinsp;0.001), and fewer PUs receiving negative pressure wound therapy (29% vs. 38%; p&thinsp;=&thinsp;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&thinsp;=&thinsp;0.018. Mean days to 100% granulation were significantly lower for CCO-treated PUs (255 vs. 282 days, p&thinsp;&lt;&thinsp;0.001). CCO-treated PUs were 47% (p&thinsp;=&thinsp;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&thinsp;=&thinsp;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.

No MeSH data available.