Abstract
PURPOSE: The roles of debridement, infection control, and moisture balance in wound healing are familiar to wound care clinicians, but these measures may not be sufficient for wound closure in all patients. In these cases, adjuvant therapies such as collagen dressings may be needed. Collagen dressings are thought to encourage wound healing by laying down a provisional biomaterial matrix that captures wound exudates because of its absorbent nature, and thus creates an environment necessary for healing. This case series describes our experience with a bovine-derived, 100% native, type I collagen in patients with chronic and persistent wounds.
CASES: This case series included 20 patients with 21 chronic wounds ranging from 0.6 to 101.4 cm2 that had been recalcitrant to prior conservative treatment and/or the use of submucosal intestinal matrix, oxidized regenerated cellulose/collagen matrix, or skin substitute. In addition to the bovine-derived 100% native collagen, standard wound care included the use of any systemic or topical antimicrobial treatments needed to specifically address wound infections. The total duration of treatment with the bovine-derived 100% native collagen was up to 12 weeks. Complete wound healing was achieved for 15 of the patients in this series; wound healing times varied from 13 to 68 days. Two additional patients achieved wound healing, using a combination of the bovine-derived 100% native collagen and other therapies, at 114 days and 107 days, respectively, after starting the wound healing process with solely the bovine-derived 100% native collagen treatment. One patient did not respond to treatment. The collagen treatment was well tolerated by the patients, with 3 incidences of dermatitis that resolved after treatment with corticosteroids.
CONCLUSION: Following a change in their chronic wound care regimen to include a bovine-derived, 100% native, type I collagen, we achieved an 83.3% (15 out of 18 patients) wound closure rate. Two patients were excluded from the data set analysis because they received additional intervention outside the parameters described in this multiple-case series.