Oxidized Regenerated Cellulose/Collagen Dressings: Review of Evidence and Recommendations

Abstract

OBJECTIVE:Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Wound dressings are one of the first lines of defense in wound management, and numerous options exist. The oxidized regenerated cellulose (ORC)/collagen dressing may offer healthcare providers a robust and cost-effective tool for use in a variety of wounds.DESIGN:A multidisciplinary panel meeting was convened to discuss the use of ORC/collagen dressings in wound care and provide practice recommendations. A literature search was conducted to provide a brief review of the peer-reviewed studies published between January 2000 and March 2016 to inform the meeting.SETTING:A 2-day panel meeting convened in February 2017.PARTICIPANTS:Healthcare providers with experience using ORC/collagen dressings. This multidisciplinary panel of 15 experts in wound healing included podiatrists, wound care specialists (doctors, certified wound care nurses, and research scientists), and an orthopedist.RESULTS:The literature search identified 58 articles, a majority of which were low levels of evidence (69.3% were level 3 or lower). Panel members identified wound types, such as abrasions, burns, stalled wounds, diabetic foot ulcers, and pressure injuries, where ORC/collagen dressing use could be beneficial. Panel members then provided recommendations and technical pearls for the use of ORC/collagen dressings in practice. Barriers to ORC/collagen dressing use were discussed, and potential resolutions were offered.CONCLUSIONS:An ORC/collagen dressing can be a critical tool for clinicians to help manage a variety of wounds. Clinical and economic studies comparing standard-of-care dressings and plain collagen dressings to ORC/collagen dressings are needed.

Injectable Scaffolds Enriched with Silver to Inhibit Bacterial Invasion in Tissue Regeneration

“…Collagen was chosen as the second injectable biomaterial to test the antibacterial activity of silver lactate and silver saccharinate formulations. Several studies, in fact, show that collagen is widely used in wound dressing and that it is a good scaffold for the delivery of substances, thanks to its effective characteristics [30,31,32]. Collagen is a fibrous protein of muco-polysaccharide nature, which constitutes the essential component of the intercellular substance of the connective tissue.…”

Antibacterial-Integrated Collagen Wound Dressing for Diabetes-Related Foot Ulcers: An Evidence-Based Review of Clinical Studies

“…Collagen with oxidised regenerated cellulose (ORC) has previously been shown to restore the wound microenvironment and its biochemical imbalances [ 68 ]. The mechanism is thought to work through binding with the inactivating proteases, including MMPs and elastase [ 69 , 70 ].…”

Combination therapy of oxidised regenerated cellulose/collagen/silver dressings with negative pressure wound therapy for coverage of exposed critical structures in complex lower‐extremity wounds

“…One of the key components of normal wound healing is the carefully controlled balance between degradation and synthesis of ECM. As such, when MMPs, reactive oxygen species, and protease inhibitors in inflammation become unbalanced, excessive proteolytic activity results in delayed wound healing 15 . A prolonged inflammatory response, dysregulated ECM degradation, and higher bacteria load have been hypothesised as major contributing factors in the delayed healing 16 …”

“…As such, when MMPs, reactive oxygen species, and protease inhibitors in inflammation become unbalanced, excessive proteolytic activity results in delayed wound healing. 15 A prolonged inflammatory response, dysregulated ECM degradation, and higher bacteria load have been hypothesised as major contributing factors in the delayed healing. 16 In addition, most complex defects with exposed tendons, bone, or wound beds that are not suitable for skin grafting are often easily dealt with using flap procedures.…”