Turning to Active Leptospermum Honey for Debridement: Case Series

Many patients entering our wound healing center have wounds that require debridement.  Although our preferred enzymatic debriding agents are no longer available there is still one enzymatic agent used in the center.   Collagenase* has demonstrated in the literature to debride more slowly than the previously available papain urea formulations.**¹  Our clinical outcomes are consistent with these findings and when collagenase is not providing optimal debridement other options are considered. 

                This case series demonstrates the lack of progress for multiple patients with lower extremity wounds undergoing collagenase applications for a treatment period ranging from 3 weeks to 6 months.  The patients had venous leg and mixed etiology ulcers.  All had multiple co-morbidities.  Due to a lack of progress or wound regression other topical dressings were trialed.  Active Leptospermum Honey (ALH)*** dressings were initiated and all wounds responded within 2 weeks demonstrating increasing amounts of granulation and decreasing amounts of slough.  ALH has been shown to facilitate autolytic debridement more quickly than hydrogel²and our experience is consistent with these outcomes.  All patients in this series demonstrated debridement and eventual wound closure with the ALH dressings. 

In addition to positive wound progression the patients were satisfied with the ease of obtaining ALH.  The patients were dissatisfied with the costs for pharmaceutical collagenase with one patient quoting a co-pay of $100.  The patients had significantly smaller co-pays to obtain ALH and this savings led to improved overall satisfaction with care.

When wound care goals are not being achieved a change in care must be considered.  With the improved healing rates and patient satisfaction our wound clinic has begun to see a shift in the topical treatments chosen most frequently.   In this series multiple patients showed enhanced debridement and healing with ALH dressings after failing treatment periods with collagenase.  Larger studies are recommended.