A comparison of collagenase to hydrogel dressings in wound debridement

Abstract

 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.