Real-world data analysis of bilayered living cellular construct and fetal bovine collagen dressing treatment for pressure injuries: a comparative effectiveness study.

Aim: To determine the effectiveness of bilayered living cellular construct (BLCC) versus a fetal bovine collagen dressing (FBCD) in pressure injuries (PRIs). Methods: A real-world data study was conducted on 1352 PRIs analyzed digitally. 1046 and 306 PRIs were treated with BLCC and FBCD, respectively. Results: Cox healing for BLCC (n = 1046) was significantly greater (p < 0.0001) at week 4 (13 vs 7%), 8 (29 vs 17%), 12 (42 vs 27%), 24 (64 vs 45%), and 36 (73 vs 56%). The probability of healing increased by 66%, (hazard ratio = 1.66 [95% CI (1.38, 2.00)]; p < 0.0001. Time to healing was 162 days for FBCD and 103 days for BLCC showing a 36% reduction in time to healing with BLCC; (p < 0.0001). Conclusion: BLCC significantly improved healing of PRIs versus FBCD.

Porous Collagen Sponge Loaded with Large Efficacy-Potentiated Exosome-Mimicking Nanovesicles for Diabetic Skin Wound Healing.

Diabetic skin wounds are difficult to heal quickly due to insufficient angiogenesis and prolonged inflammation, which is an urgent clinical problem. To address this clinical problem, it becomes imperative to develop a dressing that can promote revascularization and reduce inflammation during diabetic skin healing. Herein, a multifunctional collagen dressing (CTM) was constructed by loading large efficacy-potentiated exosome-mimicking nanovesicles (L-Meseomes) into a porous collagen sponge with transglutaminase (TGase). L-Meseomes were constructed in previous research with the function of promoting cell proliferation, migration, and angiogenesis and inhibiting inflammation. CTM has a three-dimensional porous network structure with good biocompatibility, swelling properties, and degradability and could release L-Meseome slowly. In vitro experiments showed that CTM could promote the proliferation of fibroblasts and the polarization of macrophages to the anti-inflammatory phenotype. For in vivo experiments, on the 21st day after surgery, the wound healing rates of the control and CTM were 83.026 ± 4.17% and 93.12 ± 2.16%, respectively; the epidermal maturation and dermal differentiation scores in CTM were approximately four times that of the control group, and the skin epidermal thickness of the CTM group was approximately 20 µm, which was closest to that of normal rats. CTM could significantly improve wound healing in diabetic rats by promoting anti-inflammation, angiogenesis, epidermal recovery, and dermal collagen deposition. In summary, the multifunctional collagen dressing CTM could significantly promote the healing of diabetic skin wounds, which provides a new strategy for diabetic wound healing in the clinic.

A meta-analysis examined the effect of oxidised regenerated cellulose/collagen dressing on the management of chronic skin wounds.

To assess the impact of oxidised regenerated cellulose/collagen dressing on the management of chronic skin wounds, we conducted a meta-analysis. A thorough review of the literature up to September 2022 revealed that 1521 participants had chronic skin wounds at the start of the investigations; 763 of them used oxidised regenerated cellulose/collagen dressing, while 758 received control. Using dichotomous or contentious methods and a random or fixed-effect model, odds ratios (OR) and mean difference (MD) with 95% confidence intervals (CIs) were estimated to evaluate the impact of oxidised regenerated cellulose/collagen dressing on the management of chronic skin wounds. The oxidised regenerated cellulose/collagen dressing had significantly higher complete wound healing (OR, 1.74; 95% CI, 1.06-2.85; P = .03), higher wound relative reduction percent (MD, 13.50; 95% CI, 2.39-24.61; P = .02), and lower adverse events in wound healing (OR, 0.63; 95% CI, 0.41-0.98; P = .04) compared with control in chronic skin wounds. The oxidised regenerated cellulose/collagen dressing had significantly higher complete wound healing, higher wound relative reduction percent and lower adverse events in wound healing compared with control in chronic skin wounds. The low sample size of 8 out of 10 researches in the meta-analysis and the small number of studies in several comparisons calls for care when analysing the results.

The clinical efficacy of collagen dressing on chronic wounds: A meta-analysis of 11 randomized controlled trials.

Objective: This study aims to evaluate the clinical efficacy of collagen dressing for patients with chronic wounds. Materials and methods: Relevant randomized controlled trials were searched from the databases such as PubMed, EMBASE, and the Cochrane library as of January 2022. For dichotomous outcomes and continuous outcomes, risk ratio and mean difference were calculated, respectively. Subgroup analysis was performed according to the type of chronic ulcer and follow-up. In addition, trial sequential analysis (TSA) was performed to further verify the results. Jadad score was used to assess the quality of trials. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was utilized to assess the level of evidence for outcomes. Results: In 11 studies, a total of 961 patients of whom 485 were in the collagen group. Compared with standard of care (SOC) alone, the group that added an extra collagen dressing achieved a higher wound healing rate (Risk Ratio = 1.53; 95% CI, 1.33-1.77). The collagen group also showed a higher healing velocity than the SOC group (Mean Difference, 2.69; 95% CI, 0.87-4.51). In addition, the adverse events related to dressing between the two groups were similar (Risk Ratio = 0.67; 95% CI, 0.44-1.01). Conclusion: Collagen dressing increases the wound healing rate and may be an effective and safe treatment for chronic wound management. However, more extensive research shall be conducted to substantiate these results. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=245728, identifier: CRD42021245728.

Development of stabilized dual growth factor-loaded hyaluronate collagen dressing matrix.

Patients with diabetes experience impaired growth factor production such as epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF), and they are reportedly involved in wound healing processes. Here, we report dual growth factor-loaded hyaluronate collagen dressing (Dual-HCD) matrix, using different ratios of the concentration of stabilized growth factors-stabilized-EGF (S-EGF) and stabilized-bFGF (S-bFGF). At first, the optimal concentration ratio of S-EGF to S-bFGF in the Dual-HCD matrix is determined to be 1:2 in type I diabetic mice. This Dual-HCD matrix does not cause cytotoxicity and can be used in vivo. The wound-healing effect of this matrix is confirmed in type II diabetic mice. Dual HCD enhances angiogenesis which promotes wound healing and thus, it shows a significantly greater synergistic effect than the HCD matrix loaded with a single growth factor. Overall, we conclude that the Dual-HCD matrix represents an effective therapeutic agent for impaired diabetic wound healing.

Collagen dressing in the treatment of diabetic foot ulcer: A prospective, randomized, placebo-controlled, single-center study.

AIMS: Because collagen is fundamental to wound healing and skin formation, collagen-containing dressing materials might be beneficial in treating diabetic foot ulcers (DFU), but supporting evidence is needed. Here, we examined the effectiveness and safety of collagen dressing material in DFU treatment. METHODS: This prospective, randomized, placebo-controlled, single-center study included patients with type 1 or 2 diabetes and palpable foot pulse who had Wagner grade 1 or 2 ulcers ≥1.0 cm2 with no signs of healing for ≥6 weeks. Patients were treated with foam dressing alone (control group) or with a porcine type I collagen dressing material (collagen group). Complete ulcer healing rate was the primary endpoint, and healing velocity and time to 50% size reduction were secondary endpoints. RESULTS: Thirty patients were included (collagen group: 17, control group: 13). There were no significant differences in demographic factors or baseline DFU characteristics. Compared to the control group, the collagen group presented a higher rate of complete healing [82.4% vs. 38.5%, P = .022], faster healing velocity (P < .05), and shorter median time to 50% size reduction (21 versus 42 days; hazard ratio = 1.94, P < .05). CONCLUSIONS: Wound management using collagen materials in DFUs showed faster and complete healing rate.

Comparative effectiveness of a bilayered living cellular construct and an acellular fetal bovine collagen dressing in the treatment of venous leg ulcers.

Aim: To compare the effectiveness of bilayered living cellular construct (BLCC) and an acellular fetal bovine collagen dressing (FBCD) for the treatment of venous leg ulcers. Methods: Data from WoundExpert® (Net Health, PA, USA) was used to analyze 1021 refractory venous leg ulcers treated at 177 facilities. Results: Kaplan-Meier analyses showed that BLCC (893 wounds) was superior to FBCD (128 wounds), p = 0.01 for: wound closure by weeks 12 (31 vs 25%), 24 (55 vs 43%) and 36 (68 vs 53%); reduction in time to wound closure of 37%, (19 vs 30 weeks); and improvement in the probability of healing by 45%. Conclusion: BLC versus FBCD showed significant differences in both time to and frequency of healing suggesting that BLCC may provide significant cost savings compared with FBCD.

Effectiveness of collagen/oxidised regenerated cellulose/silver-containing composite wound dressing for the treatment of medium-depth split-thickness skin graft donor site wounds in multi-morbid patients: a prospective, non-comparative, single-centre study.

Split-thickness skin grafting (STSG) is a widely used method in reconstructive surgery, but donor site wounds (DSWs) are often slow healing and painful. This prospective study evaluated the performance of a composite wound dressing containing collagen/oxidised regenerated cellulose in the treatment of medium-depth (0·4 mm) DSWs in 25 multi-morbid patients with chronic leg ulcers requiring STSG. The range of patients' ages was 44-84 years (mean 71·6 years) with DSW sizes ranging between 12 and 162 cm2 (mean 78 cm2 ). Comorbidities included anticoagulation therapy (15 patients), anaemia (11 patients), diabetes (6 patients) and methicillin-resistant Staphylococcus aureus (MRSA) ulcer colonisation (6 patients). The first dressing change was performed after 10 days. Complete reepithelialisation was observed between the 10th and 34th day (mean 17·2, median 14 days). Postoperative medium to strong bleeding occurred in only five patients (four with anticoagulation). Wound pain levels one day after harvesting were only moderate (range 0-1·5, mean 0·5, median 0·5 on a six-item scale). No wound infection was observed during the first dressing. The composite dressing used allowed for the fast healing of medium-depth DSWs with minimal or no postoperative pain and bleeding in older multi-morbid patients under anticoagulation treatment.

A clinical observation of 107 cases of collagen dressing in treatment of facial hormone dependent dermatitis / 中国生化药物杂志

Objective To investigate clinical effect of collagen dressing in treatment of facial hormone dependent dermatitis.Methods 107 patients were divided randomly into treatment group and control group.53 cases of control group were given citrate desloratadine,ompound glycyrrhizin tablets, 0.3% tacrolimus ointment, cod liver oil ointment for 4 weeks.54 cases of treatment group were given collagen dressing 25 minutesper night, based on control group.After 4 weeks of drug treatment,treatment group continued to be given collagen dressing once every other night, control group were given cod liver oil ointment twice a day, morning and night.Both groups continued to observe for 12 weeks, at the same time, 0.3% tacrolimus ointment was given once every other day.Compared effect of two groups in the short-term and long-term.Results There were no significant differences in symptom scores between the two groups pre-treatment; compared with pre-treatment,the symptom scores were decreased(P<0.05).Compared with control group, the symptoms of treatment group were lower than that of treatment group(P<0.05).Compared with control group, the clinical total effective rate was higher than treatment group ( P<0.05 ) .Conclusion The collagen dressing can improve the facial treatment of hormone-dependent dermatitis.

The clinical observation of high-energy red fight combined with human-like collagen dressing in treatment of facial corticosteroid addictive dermatitis / 中国医师进修杂志

Objective To observe the efficacy of high-energy red light combined with human-like collagen dressing in treatment of facial corticosteroid addictive dermatitis.Methods Eighty-three patients with facial corticosteroid addictive dermatitis were divided into treatment group (42 cases) and control group (41 cases) by random digits table method.All patients in 2 groups were treated with ebastine 10 mg,once a day,and vitamin E cream,twice a day.At the same time,the patients in control group were given human-like collagen dressing,once a day in the first week,then 3 times/week.On the basis of control treatment,the patients in treatment group were irradiated with high-energy red light 10 min in face,2-3 times/week.The treatment of both groups lasted for 12 weeks.The symptoms,skin lesions and untoward reaction were observed after treatment of 4,8 and 12 weeks.Results After treatment of 4 weeks,there was no statistical difference in the effective rate between 2 groups (P ＞ 0.05).After treatment of 8 and 12 weeks,the effective rates in treatment group were significantly higher than those in control group [83.3％(35/42) vs.58.5％ (24/41),90.5％ (38/42) vs.65.9％ (27/41)],there were statistical differences (P ＜ 0.05).No untoward reaction was found in 2 groups.Conclusion High-energy red light combined with human-like collagen dressing is effective and safe in treatment of facial corticosteroid addictive dermatitis.

Collagen dressing versus conventional dressings in burn and chronic wounds: a retrospective study.

OBJECTIVE: Biological dressings like collagen are impermeable to bacteria, and create the most physiological interface between the wound surface and the environment. Collagen dressings have other advantages over conventional dressings in terms of ease of application and being natural, non-immunogenic, non-pyrogenic, hypo-allergenic, and pain-free. This study aims to compare the efficacy of collagen dressing in treating burn and chronic wounds with that of conventional dressing materials. MATERIALS AND METHODS: The records of 120 patients with chronic wounds of varied aetiologies and with mean age 43.7 years were collected and analyzed. The patients had been treated either with collagen or other conventional dressing materials including silver sulfadiazine, nadifloxacin, povidone iodine, or honey (traditional dressing material). Patients with co-morbidities that could grossly affect the wound healing like uncontrolled diabetes mellitus, chronic liver or renal disease, or major nutritional deprivation were not included. For the purpose of comparison the patients were divided into two groups; 'Collagen group' and 'Conventional group', each having 60 patients. For assessment the wound characteristics (size, edge, floor, slough, granulation tissue, and wound swab or pus culture sensitivity results) were recorded. With start of treatment, appearance of granulation tissue, completeness of healing, need for skin grafting, and patients' satisfaction was noted for each patient in both groups. RESULTS: With two weeks of treatment, 60% of the 'collagen group' wounds and only 42% of the 'conventional group' wounds were sterile (P=0.03). Healthy granulation tissue appeared earlier over collagen-dressed wounds than over conventionally treated wounds (P=0.03). After eight weeks, 52 (87%) of 'collagen group' wounds and 48 (80%) of 'conventional group' wounds were >75% healed (P=0.21). Eight patients in the 'collagen group' and 12 in the 'conventional group' needed partial split-skin grafting (P=0.04). Collagen-treated patients enjoyed early and more subjective mobility. CONCLUSION: No significant better results in terms of completeness of healing of burn and chronic wounds between collagen dressing and conventional dressing were found. Collagen dressing, however, may avoid the need of skin grafting, and provides additional advantage of patients' compliance and comfort.

Clinical and histological evaluation of two dressing materials in the healing of palatal wounds.

BACKGROUND: Free gingival grafts have been used extensively for gingival augmentation procedures, but are associated with postoperative morbidity because of the open palatal wound. This study compares the clinical efficiency of two dressing materials, a non-eugenol-based dressing (Coe-Pak™) and a collagen dressing (Colla Cote(®)) on palatal wound healing. MATERIALS AND METHODS: Thirty-two patients in the age group of 25-50 years, who required gingival augmentation, were selected. Free gingival graft was harvested from the palatal mucosa and the wound was then protected using Coe-pak(®) in control group and Colla Cote(®) in test group. The subjective parameters pain and burning sensation were recorded on the 2(nd) and 7(th) day and the objective parameters colour and consistency were recorded on the 7(th) and 42(nd) day, using a visual analog scale. Thickness of the mucosa was measured using K file at baseline and 42(nd) day. Histological examination was done on 42(nd) day. RESULTS: The subjective and objective parameters showed significant improvement in the test group when compared to control group. Histologically, there was a greater evidence of collagen formation and turn over in the test group than control group. CONCLUSIONS: Collagen-based dressing may thus offer significantly greater advantages over the traditional non-eugenol dressings.

Treatment of Deep Second Degree Burn Wound using Heterogenic Type I Collagen Dressing

PURPOSE: The purpose of this study is to evaluate the effectiveness and validity of the wound dressing using heterogenic type I collagen dressing (Collaheal(R)). METHODS: From January 2010 to April 2010, 46 burn patients with deep second degree or third degree burn wound were treated with Collaheal(R). And we followed up the patients to assess the treatment result with Vancouver scar scale after 6 months. RESULTS: Of the 46 patients, 42 patients had deep second degree burn only and 4 patients had deep second degree burn with third degree burn. It took 18.5 days to re-epithelialize for patients with deep second degree burn and 40.5 days for third degree burn wound. After 6 months, follow-up was performed to assess the wound result. We can observe that 24 patients had mild scar and 5 patients had moderate scar and 2 patients had severe scar. The severity of scar increased as the re-epithelialization period increased. CONCLUSION: It took 18.5 days to re-epithelialize the deep second degree burn wound with collagen dressing. And the long term result was good. Type I collagen dressing can be used for treatment option for the patients with deep second degree burn wound and the patients with small third degree burn wound who cannot be operated.

Use of collagen in extraoral wounds.

The basic fundamental elements that collagen bring into the wound activity are its hemostatic effect, its interaction with platelets and interaction with fibronection, increase in fluid exudates, increase in cellular components (macrophages) and support for fibroblastic proliferation into wound activity. In this way collagen plays a significant parts in almost every function of the body. Previously broad use of collagen was stifled because of cost, recent advances made it possible to develop cost effective collagen. In this study twenty patients of maxillofacial wounds were treated with the use of collagen. The results were satisfactory without any significant complication.

Diabetic Ulcers Treated with Bi-layered Collagen Membrane / 대한피부과학회지

Diabetic foot ulcer is a serious clinical problem with significant medical and economic effects on health systems worldwide. Some patients undergo amputation and others experience disability for an extended period of time. Treatment of diabetic foot ulcer is complex and difficult. Even with proper management, the wounds may not heal as well as expected. To promote wound healing, many advanced topical dressing materials have been developed. Among them, bi-layered collagen membrane, which is composed of collagen and hyaluronic acid, is believed to enhance wound healing. Herein we report two cases of diabetic foot ulcer which were successfully treated using bi-layered collagen membranes.

Diabetic Ulcers Treated with Bi-layered Collagen Membrane / 대한피부과학회지

Diabetic foot ulcer is a serious clinical problem with significant medical and economic effects on health systems worldwide. Some patients undergo amputation and others experience disability for an extended period of time. Treatment of diabetic foot ulcer is complex and difficult. Even with proper management, the wounds may not heal as well as expected. To promote wound healing, many advanced topical dressing materials have been developed. Among them, bi-layered collagen membrane, which is composed of collagen and hyaluronic acid, is believed to enhance wound healing. Herein we report two cases of diabetic foot ulcer which were successfully treated using bi-layered collagen membranes.