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Methods: Retrospective de-identified electronic medical records from 2007-2013 were extracted from the U.S. Wound Registry (USWR). The USWR is a registry of chronic wounds from more than 100 HOPD wound centers in the U.S. and Puerto Rico. A propensity score model using a 1 to 1 matching approach was performed to test for treatment effect and adjust for covariance between wounds that treated CI versus medicinal honey.
Results: A total of 9,313 patients, 22,312 wounds, and 186,023 visits for VLU were identified. The majority of patients were female (51.9%) with an average age of 61.6 (SD=17.7). Approximately 21.3% had a history of hypertension, 8.3% had a history of venous insufficiency with diabetes, and 2.5% received immunosuppressive agents. Mean baseline wound surface area was 7.9cm2 (SD=14.4). The average wound age at baseline was 8.5 months (SD=27.8) and average treatment duration was 2.9 months (SD=4.9). Of the 22,312 VLUs, approximately 3.3% received CI (n=738) and 2.0% received medicinal honey (n=441). VLUs treated with medicinal honey were significantly more likely to be active and chronic after 60 days (p<0.0001) relative to wounds treated with CI (12% versus 8%, respectively). Furthermore, VLUs treated with CI were significantly more likely (p<0.0001) to close by the end of therapy relative to wounds treated with medicinal honey (51% versus 31%, respectively). Finally, VLUs treated with CI were significantly more likely (p<0.01) to achieve 100% granulation by the end of therapy compared to wounds treated with medicinal honey (36% versus 18%, respectively).
Conclusion: Over the course of therapy VLUs treated with CI demonstrate greater clinical improvement, particularly total granulation and closure than VLUs treated with medicinal honey.