Healing pressure ulcers with collagen or hydrocolloid: a randomized, controlled trial.
OBJECTIVE
To compare the effects of topical collagen and hydrocolloid on pressure ulcer healing.


METHODS
Randomized (allocation concealed), single-blind (outcome assessors), controlled trial with 8-week follow-up.


METHODS
Eleven nursing homes in central Illinois.


METHODS
Sixty-five patient-residents with Stage II or III pressure ulcers: median age 83.1, median Braden score 12, 63% female, 80% Stage II ulcers, and 20% Stage III ulcers. Exclusion criteria included cellulitis and osteomyelitis.


METHODS
Thirty-five patients were allocated to topical collagen daily, 30 to topical hydrocolloid twice weekly.


METHODS
The primary outcome was complete healing within 8 weeks. Secondary outcomes were time to heal, ulcer area healed per day, linear healing of wound edge, and cost of therapy.


RESULTS
Analysis by intention to treat revealed similar complete ulcer healing within 8 weeks in collagen (51%) and hydrocolloid (50%) recipients (difference 1%, 95% confidence interval (CI) = 26-29%). Mean healing time was similar: collagen healed in 5 weeks (95% CI = 4-6), hydrocolloid healed in 6 weeks (95% CI = 5-7). Mean area healed per day was 6 mm(2)/d in both treatment groups. Mean linear healing of the wound edge was 3 mm in both groups. In multivariate analysis, baseline ulcer depth was the only independent predictor of complete ulcer healing within 8 weeks (odds ratio = 0.56, 95% CI = 0.38-0.81). Cost analysis favored hydrocolloid.


CONCLUSIONS
There were no significant differences in healing outcome between collagen and hydrocolloid. Collagen was more expensive and offered no major benefits to patients otherwise eligible for hydrocolloid treatment.
Graumlich
James F
JF
Department of Biomedical and Therapeutic Sciences and Medicine, University of Illinois College of Medicine, Peoria, Illinois 61605, USA. jfg@uic.edu
Blough
Linda S
LS
McLaughlin
Richard G
RG
Milbrandt
Joseph C
JC
Calderon
Cesar L
CL
Agha
Syed Abbas
SA
Scheibel
L William
LW
D000368:Aged; D000369:Aged, 80 and over; D003094:Collagen / Q000191:economics / Q000627:therapeutic use*; D003102:Colloids / Q000191:economics / Q000627:therapeutic use*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D003668:Pressure Ulcer / Q000188:drug therapy* / Q000191:economics; D016037:Single-Blind Method
D003102:Colloids; D003094:Collagen