Randomized controlled trial on collagen/oxidized regenerated cellulose/silver treatment

TY - JOUR

T1 - Randomized controlled trial on collagen/oxidized regenerated cellulose/silver treatment

AU - Gottrup, Finn

AU - Cullen, Breda Mary

AU - Karlsmark, Tonny

AU - Bischoff-Mikkelsen, Morten

AU - Nisbet, Lorraine

AU - Gibson, Molly Camilla

N1 - © 2013 by the Wound Healing Society.

PY - 2013/3

Y1 - 2013/3

N2 - Collagen/oxidized regenerated cellulose (ORC)/silver therapy has been designed to facilitate wound healing by normalizing the microenvironment and correcting biochemical imbalances in chronic wounds. The aim of this study was to compare collagen/ORC/silver therapy to control (standard treatment). Patients with diabetic foot ulcers were randomized to either collagen/ORC/silver (24) or control treatment (15). Wound area measurements and wound fluid samples were taken weekly. Protease levels were measured in wound fluid samples to investigate differences between responders (≥50% reduction in wound area by week 4) and nonresponders (<50% reduction in wound area by week 4). There were significantly more responders in the collagen/ORC/silver group compared with the control group (79% vs. 43%, p = 0.035). There were significantly fewer withdrawals from the study because of infection in the collagen/ORC/silver group compared with the control group (0% vs. 31%, p = 0.012). The sum of matrix metalloproteinase-9 and elastase concentration was higher in nonresponders compared with responders at baseline (p = 0.0705) and week 4 (p = 0.012). The results suggest that collagen/ORC/silver normalizes the wound microenvironment and protects against infection, resulting in improved wound healing. It was also demonstrated that measuring a combination of proteases may be a more relevant prognostic healing marker than any individual protease alone.

AB - Collagen/oxidized regenerated cellulose (ORC)/silver therapy has been designed to facilitate wound healing by normalizing the microenvironment and correcting biochemical imbalances in chronic wounds. The aim of this study was to compare collagen/ORC/silver therapy to control (standard treatment). Patients with diabetic foot ulcers were randomized to either collagen/ORC/silver (24) or control treatment (15). Wound area measurements and wound fluid samples were taken weekly. Protease levels were measured in wound fluid samples to investigate differences between responders (≥50% reduction in wound area by week 4) and nonresponders (<50% reduction in wound area by week 4). There were significantly more responders in the collagen/ORC/silver group compared with the control group (79% vs. 43%, p = 0.035). There were significantly fewer withdrawals from the study because of infection in the collagen/ORC/silver group compared with the control group (0% vs. 31%, p = 0.012). The sum of matrix metalloproteinase-9 and elastase concentration was higher in nonresponders compared with responders at baseline (p = 0.0705) and week 4 (p = 0.012). The results suggest that collagen/ORC/silver normalizes the wound microenvironment and protects against infection, resulting in improved wound healing. It was also demonstrated that measuring a combination of proteases may be a more relevant prognostic healing marker than any individual protease alone.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Bandages

KW - Biological Markers

KW - Cellulose, Oxidized

KW - Collagen

KW - Diabetic Foot

KW - Exudates and Transudates

KW - Female

KW - Fibrin Foam

KW - Humans

KW - Inflammation

KW - Male

KW - Matrix Metalloproteinase 1

KW - Matrix Metalloproteinase 9

KW - Middle Aged

KW - Pancreatic Elastase

KW - Silver

KW - Treatment Outcome

KW - Wound Healing

U2 - 10.1111/wrr.12020

DO - 10.1111/wrr.12020

M3 - Journal article

C2 - 23438054

SN - 1067-1927

VL - 21

SP - 216

EP - 225

JO - Wound Repair and Regeneration

JF - Wound Repair and Regeneration

IS - 2

ER -