Use of Oxidized Regenerated Cellulose (ORC)/Collagen/Silver-ORC Dressing Alone or Subsequent to Advanced Wound Therapies in Complex Wounds: A Case Series

Complex wounds are difficult to treat and often require several different interventions before wound healing is achieved. This may be mitigated by optimizing the wound for healing. Oxidized regenerated cellulose (ORC)/collagen/silver-ORC dressings have been shown to help optimize the wound environment and promote the development of granulation tissue.^1;2 Additionally, these dressings have been used to prepare the wound bed prior to skin grafting with positive results.³ Use of ORC/collagen/silver-ORC dressings alone or subsequent to advanced wound therapies in 17 patients is presented. Oral or intravenous antibiotics were given, as necessary. Each wound underwent sharp debridement. Patients received either ORC/collagen/silver-ORC dressings with a secondary dressing alone (n=12) or subsequent to negative pressure wound therapy (NPWT^†; n=5). Dressing changes occurred every 2-3 days. Off-loading was recommended for all patients. Seventeen patients (11 males, 6 females) with an average age of 68.4 years (range: 45-98) were treated. The most common comorbidities in this patient population included hypertension (n=15), diabetes (n=11), obesity (n=10), coronary heart disease (n=9), and tobacco use (n=7). Wound types included were diabetic foot ulcers (n=9), surgical wounds (n=5), trauma (n=1), and ulcer secondary to chronic gout with tophi (n=1). Nine patients required the use of epidermal grafting to promote wound closure. In these patients, an epidermal harvesting system^‡ was utilized. All wounds were fully closed in all patients. In these patients, use of ORC/collagen/silver-ORC dressings alone or subsequent to advanced wound therapies led to full wound closure. In 3 patients, this treatment plan contributed to successful limb/toe preservation.

*PROMOGRAN PRISMA™ Matrix, ^†V.A.C.® Therapy, ^‡CELLUTOME™ Epidermal Harvesting System, KCI, now part of 3M Company, San Antonio, TX

References
1. Cullen B. ORC/Collagen/Silver-ORC matrix promotes cell growth in the presence of chronic wound fluid. Presented at the Symposium on Advanced Wound Care, April 28-May 1, 2007, Tampa, FL 2007.
2. Hart J, Silcock D, Gunnigle S, Cullen B, Light ND, Watt PW. The role of oxidised regenerated cellulose/collagen in wound repair: effects in vitro on fibroblast biology and in vivo in a model of compromised healing. Int J Biochem Cell Biol 2002;34:1557-1570.
3. Tausche AK, Sebastian G. Wound conditioning of a deep tissue defect including exposed bone after tumour excision using PROMOGRAN Matrix, a protease-modulating matrix. Int Wound J 2005;2:253-257.