Use of Collagen Scaffolds in Conjunction with NPWT for the Care of Complex Wounds: Clinical Report

Abstract

Open wounds treatment is very often a challenge for both the physician and patient. They require long term complex treatment with surgical debridement, dressing changing, additional therapies including expensive medication, with a high risk of failure. The most difficult to treat are the diabetic wounds and those that are associated with advanced arterial disease. In these special cases, the peripheral vascularization is severely impaired and the complications are imminent. Sixteen patients were selected from those appearing to our hospital departments of orthopedic and plastic surgery. Inclusion criteria included patients with a recurrent mixed fibrotic and granular wound base following trauma or diabetes, in which NPWT was indicated, without exclusion criteria. Patients enrolled were treated with regularly scheduled NPWT dressing change and using of a collagen scaffold. Patients were followed until healing, with visual representations of wound progression and time to full healing recorded. Both applications of these therapies appeared to accelerate the wound healing by clearing degenerative fibrous tissue and expediting wound granulation without additional complication. Some of the patients were healed partially and plastic surgery techniques were applied. Use of collagen scaffolds in conjunction with negative pressure wound therapy in the care of complex wounds is a reliable and effective method combining both the new granular tissue formation capacity of the scaffold to hold osteoblasts. In our experience, we have noticed that the patients benefit greatly when collagen scaffolds is combined with NPWT. It is our belief that this combination therapy combines the molecular clearing of non-viable collagen with the wound granulation necessary to advance complex wounds in healing.

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

“…Our described combination technique of ORC/collagen/ silver and NPWT was described earlier in a similar fashion. 21,22 In these two studies, the use of collagen had been proposed to accelerate the growth of granulation tissue by providing a bio-scaffold for the retention of fibroblasts to lay new tissue, and NPWT stimulated healing by increasing local tissue perfusion, hence facilitating adherence of the tissue layers in the wound bed. 18,19 These studies reported reduction in wound area and volume upon addition of ORC/collagen dressings to conventional NPWT in complex wounds.…”

A Comparison of the Biomechanical Performance of 3 Negative Pressure Wound Therapy Foams

“…The most frequent subdrape materials used in modern NPWT systems are foams, with the black polyurethane (PU) foam being the first, followed by “white” and then “green” foams. Other nonfoam materials such as cotton gauze are used, and a variety of materials are being developed and tested for possible incorporation into vacuum-assisted NPWT systems 3–11…”

“…Other nonfoam materials such as cotton gauze are used, and a variety of materials are being developed and tested for possible incorporation into vacuum-assisted NPWT systems. [3][4][5][6][7][8][9][10][11] Research in vacuum-assisted NPWT technologies has also evaluated subdrape materials with the intention of expanding the clinical utility of this component of the NPWT system. 11 Th e fi rst example comprised a silver-impregnated version of the black foam designed to provide antimicrobial activity.…”

“…Negative pressure wound therapy (NPWT) is a popular treatment option for a variety of chronic wounds, surgical incisions, and related conditions such as enterocutaneous or enteroatmospheric fistulae 1–8. The primary principle underlying NPWT, application of suction to a wound to promote healing, traces its roots to antiquity 1.…”

“…Negative pressure wound therapy (NPWT) is a popular treatment option for a variety of chronic wounds, surgical incisions, and related conditions such as enterocutaneous or enteroatmospheric fi stulae. [1][2][3][4][5][6][7][8] Th e primary principle underlying NPWT, application of suction to a wound to promote healing, traces its roots to antiquity. 1 Th e technology has evolved beyond the use of dedicated people who would use their mouths to suck on open skin wounds to the use of bell jars and hand pumps, which would mitigate the unsanitary practice of wound sucking.…”