The role of collagenase ointment in acute burns: a systematic review and meta-analysis.
Christopher H Pham, Zachary J Collier, Mike Fang and 2 others
PMID 30767636WHAT IT FOUND
Collagenase ointment, used alone or with polymyxin B sulfate, cleaned and healed acute burns faster than silver sulfadiazine in studies.
Infection outcomes were not clearly different, and evidence is low.
Key findings
01In the included burn studies, Santyl, used alone or with polymyxin B sulfate, had shorter time-to-clean and time-to-healed than silver sulfadiazine; the effect of Santyl alone cannot be separated in the combination study.
02The meta-analysis found no significant difference in wound infection odds between collagenase-treated and non-collagenase-treated patients (OR 2.52).
03Nurses surveyed about dressing changes preferred collagenase ointment (83%) because dressings were cleaner, pseudoeschar was absent, and pain during dressing changes appeared less.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The review included six human studies after screening 706 articles, and the authors state that large randomized controlled trials are needed. The included studies were prospective, and a comparison used Santyl plus polymyxin B sulfate, so the effect of Santyl alone cannot be separated. The search was limited to English language, full-text availability, and human studies. The meta-analysis included only studies with a control cohort and variance. Infection results were not significant, and the authors call for larger studies to understand infection risk. Cost findings came from single-institution estimates and a comparison, and the review says cost-effectiveness is difficult to estimate.
The easy way to misread this
Do not conclude that Santyl is proven to prevent infection or save money. The meta-analysis found no significant difference in wound infection odds (OR 2.52), Santyl has no intrinsic antimicrobial action, and cost was higher than silver sulfadiazine in a comparison (+$842); large randomized trials are needed.