The role of collagenase ointment in acute burns: a systematic review and meta-analysis
Open Access
- 1 February 2019
- journal article
- review article
- Published by Mark Allen Group in Journal of Wound Care
- Vol. 28 (Sup2) , S9-S15
Abstract
Objective: A systematic review and meta-analysis was performed to summarise the state of the literature in regard to the efficacy and uses of clostridial collagenase ointment (CCO) in the burn patient. Method: A systematic review of articles available on PubMed, Scopus and OvidSP Medline was performed. Keywords used in the search process included burns, thermal injury, collagenase, enzymatic debridement, wound care. Reviews, case reports, independent abstracts, consensus and opinion papers were excluded. A meta-analysis was performed for articles fitting inclusion criteria. Results: Following screening, six relevant articles were identified for systematic review. Few studies, with limited sample sizes, argue that CCO may be an effective debriding agent. It may also accelerate wound healing and avoid the pain associated with mechanical debridement. CCO lacks antimicrobial activity but the risk of burn wound infection does not appear to be significantly different than when using silver-impregnated products. CCO is more expensive than traditional wound care products but may help halt burn depth conversion and prevent the need for surgery. Conclusion: CCO may be a safe and effective debridement agent for burn wounds with respect to decreasing wound healing time and minimising pain without increasing the risk of infection. It should be used on a case-by-case basis due to its financial cost, which may be offset by its ability to manage burns non-operatively.Keywords
This publication has 18 references indexed in Scilit:
- An Overview of the Use of Bromelain-Based Enzymatic Debridement (Nexobrid®) in Deep Partial and Full Thickness Burns: Appraising the EvidenceJournal of Burn Care & Research, 2018
- Eschar removal by bromelain based enzymatic debridement (Nexobrid ® ) in burns: An European consensusBurns, 2017
- Enzymatic debridement of deeply burned faces: Healing and early scarring based on tissue preservation compared to traditional surgical debridementBurns, 2017
- Our initial learning curve in the enzymatic debridement of severely burned hands—Management and pit falls of initial treatments and our development of a post debridement wound treatment algorithmBurns, 2017
- A novel rapid and selective enzymatic debridement agent for burn wound management: A multi-center RCTBurns, 2014
- Topical silver sulfadiazine vs collagenase ointment for the treatment of partial thickness burns in children: a prospective randomized trialJournal of Pediatric Surgery, 2012
- Efficacy of enzymatic debridement of deeply burned handsBurns, 2012
- Safety and efficacy of a proteolytic enzyme for enzymatic burn débridement: a preliminary reportBurns, 2004
- Enzymatic debridement of burn wound with collagenase in children with partial-thickness burnsBurns, 2002
- Collagenase Ointment and Polymyxin B Sulfate/Bacitracin Spray Versus Silver Sulfadiazine Cream in Partial-Thickness Burns: A Pilot StudyJournal of Burn Care & Rehabilitation, 1994