Collagenase for Wound Debridement in the Neonatal Intensive Care Unit: A Retrospective Case Series

The use of collagenase for enzymatic wound debridement has been studied extensively and has been established as the standard of care for nonhealing and necrotic wounds in individuals for whom surgical intervention is not an option. Collagenase has been shown to be effective in adults but has been studied in a limited capacity in infants and neonates. The purpose of this study was to investigate the use of collagenase in the neonatal intensive care unit (NICU).

Retrospective chart review of infants and neonates admitted to the NICU at Arkansas Children's Hospital with nonhealing wounds for which collagenase was used for wound healing over a 1-year time period. Six wounds were identified: five surgical wound dehiscence and one intravenous infiltrate.

Before the use of collagenase, five of the six wounds had been treated with an alternative dressing. Once collagenase was initiated, three of these wounds reached complete granulation and closure in less time than in the episode of prior therapy. The number of days to reach 100% granulation once treated with collagenase was 5 to 18 days (mean 12.2 days). Surgical intervention for the debridement and closure of these wounds was not required, providing cost savings to the patient. Daily wound care was completed with negligible pain recordings.

The use of collagenase for enzymatic debridement can be beneficial, safe, and effective for the treatment of nonhealing and necrotic wounds in infants and neonates.