A retrospective study of the effects of clostridial collagenase ointment and negative pressure wound therapy for the treatment of chronic pressure ulcers

Abstract

Nonhealing, chronic pressure ulcers present a continuous challenge in the global health care venue, with decreased mobility and the effects of aging on skin placing the elderly at particular risk. Debridement is an important process to decrease risk of infection and promote healing. Enzymatic debridement with, for example, clostridial collagenase ointment (CCO) has been shown to assist with the achievement and maintenance of a clean wound bed in preparation for closure. Negative pressure wound therapy (NPWT) has also been used successfully for the treatment of wounds. Although conclusive research has demonstrated positive independent effects of both CCO and NPWT as treatments for chronic pressure ulcers, there are no known published studies that have investigated the 2 as a conjunctive treatment.

Materials and methods: A retrospective analysis of 114 adult patients was conducted to assess wound healing of chronic pressure ulcers in a setting with medically complex patients. Two groups were established comparing those who received NPWT alone to those who received NPWT plus CCO. The study sample included 67 patients treated with NPWT + CCO and 47 patients who received only NPWT.

Results: Results were similar for both treatment groups with mean values indicating the cohorts were closely aligned with respect to wound size, complexity, length of long-term acute care hospital stay, and duration of NPWT. The patients who received NPWT + CCO demonstrated statistically significant changes in several key areas including initial Bates-Jensen Wound Assessment Tool (BWAT) score, changes in the overall BWAT score and in the necrotic tissue domain.

Conclusion: Data analysis from this retrospective study indicates patients who received both therapies (NPWT + CCO) demonstrated improved outcomes in speed of debridement and rate of wound closure compared to those who received NPWT alone.