A clinical and cost comparison of Active Leptospermum honey versus collagenase in long term care

Purpose: 

To evaluate whether active leptospermum honey gel (ALHG) debrides in a more cost-effective and timely manner than collagenase in wounds of geriatric patients residing in long term care facilities.

Methods: 

Six chronic full-thickness wounds requiring debridement were chosen for evaluation.  The wounds were initially sharp debrided if necessary then either a treatment plan of ALHG with bordered silicone foam (BSF) changed 2-3 x/week or daily collagenase with gauze and tape was initiated. Wound measurements, volume, area, cost of treatment, days requiring treatment, condition of the residents’ skin during and after, and nursing satisfaction was documented. 

Results: 

Wound healing trajectory and volume reduction were greater in the ALHG group over the collagenase group demonstrating improved healing rates of chronic ulcers. The ALHG wounds also had decreased amounts of slough while showing increased amounts of granulation tissue, both to a greater extent than the collagenase wounds, which shows more effective debridement in the ALHG group.  Utilizing facility costs for one week of treatment the average cost of ALHG treatment was $48.00/week including advanced secondary dressing and skin prep barrier.  The cost of one week of treatment of collagenase group was $147.52 including just collagenase and gauze costs.  Overall cost to healing was less in the ALHG group.

Conclusion: 

Both the ALHG and collagenase wounds showed clinical improvement, the ALHG group clearly had faster healing rates and better facilitated debridement.  In addition, ALHG was shown to be three times more cost effective than collagenase treatment. The nurses were more satisfied with the less frequent dressing changes of ALHG.  There is need for further comparative research on this topic including the study of other wound types.