Study compares collagen ointment to hypertonic gel
Hypertonic gel removes necrotic tissue more effectively than does collagenase ointment, according to a consortium of researchers headed by Marie Brown-Etris, RN, CETN, a wound consultant in Philadelphia. In addition, the group says that the use of hypertonic gel was notably less expensive than collagenase ointment when the two compounds were used for identical purposes. A wound care consultant not allied with the researchers calls the results "interesting," but notes that the study was sponsored by Molnlycke Health Care of Eddystone, PA, which manufactures a hypertonic saline gel wound dressing.
The research team set out to evaluate and compare the efficacy of enzymatic debridement (collagenase) with a variation of autolytic debridement (hypertonic gel). The team notes that moist, devitalized tissue supports the growth of pathological organisms, and the removal of necrotic tissue favorably alters the healing environment of a wound, according to the AHCPR Clinical Guidelines for Pressure Ulcer Treatment.
The multicenter study was prospective, randomized, and controlled. Fifty-two subjects were divided into two groups. Patients with initial eschar who completed the full four-week study were from long-term care centers or in home care. Most had a wound for three months or less. The wounds were mostly nonresponsive to prior treatment. The percentage of eschar remaining at the end of the four weeks for the 20% hypertonic saline gel group was 53% lower than that of the collagenase group. There was a more rapid decrease in the eschar level for the hypertonic saline group.
The researchers write that "there is strong directionality in this data favoring the hypertonic saline gel."
The length of time in days to complete eschar removal was 16.3 days for the hypertonic saline group compared with 22.7 days in the collagenase group. The average number of days of product use to total eschar removal for the hypertonic saline group was 28% lower than that of the collagenase group.
The investigators estimated that the total cost of the hypertonic saline gel was $509, while the cost of the collagenase was $1,995. The final study results, which covered 100 subjects, were recently tabulated and will be released in the near future.
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