Side by Side: A case series comparing cost and effectiveness of Leptospermum honey and collagenase

Problem:  With a lack of debridement products available and the high costs associated with enzymatic debriders a side by side study was performed to evaluate the efficacy of all products at hand.  The following outcome criteria were evaluated:  removal of necrotic tissue, wear time, healing, odor reduction, pain reduction and cost.

Approach:  Three patients with bilateral lower extremity ulcers were treated utilizing both Active Leptospermum Honey (ALH)* and Collagenase**.  ALH was applied to wounds on the right LE and collagenase to the left.  Wound beds all contained yellow slough.  ALH was changed 3x weekly and collagenase daily.  The patients were asked questions daily regarding pain, odor, and comfort of dressings.

Outcomes:   

-Patients reported comfort with both dressings

            -ALH was noted to remove slough in a shorter time period

            -ALH reduced malodor, collagenase did not

            -1 person reported a slight tingle 1x from ALH, no pain or other reactions noted

            -Collagenase had to be changed daily but ALH changes were only 3x weekly

            -Facility cost of collagenase for 2011: 274 units for a total of $18,642.50

            -ALH cost for purchasing 274 units $3,288

Conclusions: 

            -Collagenase cost is $68/unit with an average of one unit/week required

            -ALH cost is $12/unit with an average of less than one unit every two weeks

            -Necrotic tissue lifted faster with ALH treatment

            -Pain was reduced with ALH in comparison to collagenase

            -Nursing time/cost savings was appreciated for LEs receiving ALH treatment

            -Patients reported increased quality of life with diminished pain, less frequent        dressing changes, reduced odor, and improved healing

            -Overall cost savings are significant for ALH vs. collagenase

            -ALH has additional properties, including antimicrobial benefits that were not       seen in collagenase product