Oxidized Regenerated Cellulose ORC/Collagen Dressings Versus Standard of Care Over Multiple Wound Types: A Systematic Review and Meta-Analysis

Abstract

Background: Oxidized regenerated cellulose (ORC)/collagen* and ORC/collagen/silver-ORC^† dressings help maintain a physiologically moist wound environment conducive to granulation tissue formation, epithelialization, and wound healing. A growing body of literature exists; however, a more comprehensive assessment is needed. This systematic meta-analysis was performed to evaluate the performance of ORC/collagen dressings compared to standard wound dressings.

Methods: A systematic literature search was performed using PUBMED, OVID, EMBASE, and QUOSA. Published studies and conference abstracts, were assessed between January 1, 1996 and July 27, 2020. Comparative studies completed by December 31, 2019, in English, evaluating ORC/collagen dressings, and a study population ≥ 10 were included in the meta-analysis. Patient demographics, wound healing outcomes, and/or health economic outcomes were extracted. Random-effect model was utilized to assess the mean effect of ORC/collagen dressings.

Results: A total of 559 studies were identified. After duplicates and articles that did not meet inclusion criteria were removed, 20 studies were included in the meta-analysis. Diabetic foot ulcers (DFUs), venous leg ulcers, and mixed pressure ulcers were the most commonly reported wound types. Patient comorbidities included diabetes, hypertension, and peripheral artery disease. Wound closure showed a statistically significant effect in favor of ORC/collagen dressings (Odds ratio = 3.41, 95% confidence interval [CI, 1.15, 10.1], p=0.027) when compared with standard wound dressings. Percent area reduction was also significantly greater in the ORC/collagen group (effect estimate of standard mean differences = 1.11, 95% CI [0.32, 1.90], p=0.006). Inconclusive evidence prevented the assessment of time to complete healing. Limited reporting prevented the assessment of total days of therapy, number of dressing applications, pain score, matrix metalloproteinase concentration, and elastase, plasmin, and gelatinase activity.

Conclusions: In this systematic review/meta-analysis, statistically significant increase in wound closure rates and reduction in wound area were observed in patients receiving ORC/collagen dressings compared to standard wound dressings.

*PROMOGRAN™ Matrix Wound Dressing, ^†PROMOGRAN PRISMA™ Matrix, Systagenix Wound Management Ltd., Gargrave, UK