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Description
"Introduction
Wound healing is a complex process that involves numerous cell types, cytokines, chemokines, growth factors and extracellular matrix (ECM) components, which work synergistically to achieve healing1,2. When the healing process fails to proceed through the four physiological phases, the wound is referred to as a chronic wound1,2,4,5. Chronic wounds are a significant global problem, causing patient morbidity and a substantial financial burden on health services worldwide. The rising prevalence of chronic wounds puts increasing pressure on global health services, calling for the development of therapies that can relieve both patients and healthcare systems of this economic and societal burden 6,7.
Collagen-based dressings are a large class of dressings that offer numerous beneficial properties for the treatment of recalcitrant wounds8-11. Commercially available collagen-based wound dressings differ in composition but present similar claims. There is a lack of comparative data to differentiate between these dressings and understand their mode of action.
Methodology
The dressings chosen for analysis were a control non-woven dressing (3M, Saint Paul, MN, US), 3M™ Promogran™ Protease Modulating Matrix and 3M™ Promogran Prisma™ Wound Balancing Matrix (3M, Saint Paul, MN, US), Puracol® (Medline Industries Inc., Northfield, IL, US), ColActive® Plus (Covalon Technologies Ltd., Mississauga, Ontario, Canada) and UrgoStart® (UrgoMedical, Chenôve, France), a synthetic dressing with similar claims to collagen-based dressings. Thirty-six diabetic (db/db) female mice received two full-thickness excisional wounds. Wounds were treated with a pre-moistened control or collagen dressings (12 wounds per group). Dressings were changed or re-applied after 3 days according to the products’ IFU. After 7 days, macroscopic images were taken, and wounds harvested. Wounds were bisected and processed for histological and biochemical analysis.
Results
Wound area calculated from the macroscopic images for all wounds showed that 3 of the 4 collagen dressings and UrgoStart promote healing compared to the control (p=<0.05), achieving 60-70% closure within 7 days. Analysis of wound parameters from histological sections revealed greater re-epithelialisation compared to the control. Granulation tissue area, wound length and re-epithelialisation varied amongst the collagen dressings but no significant differences were observed.
Conclusions
Preliminary results show that collagen-based dressings promote healing of diabetic murine wounds to a better extent than control dressing. However, further in vitro analyses are needed to further elucidate these initial results. These results may help healthcare professionals with a greater understanding of how collagen-based dressing can modulate healing of chronic wounds.
References
1. Uluer E.T. et al. Wound Heal. 67-77, 2017
2. Gabriel A et al. Wounds 32, S1-S17, 2020
3. Marshall C.D. et al. Adv. Wound Care 7(2):29-45, 2018
4. Panasci K. Acute Care Handbook for Physical Therapist 283-311, 2014
5. Järbrink K. et al. Syst Rev 6:1-7, 2017
6. Wu S. et al. Adv. Skin & Wound Care 30:S1-S18, 2017
7. Rodrigues M. et al. Phys. Rev. 99:665-706, 2019
8. Pallaske F et al. J. Wound Care 27:692-702, 2018
9. Gould LJ Adv. Wound Care 5:19–31, 2016
10. Romanelli M et al. J. Wound Care 24:543–7, 2015
11. Holmes C et al. Metab. Syndr. Obes. Targets Ther. 6:17, 2013"
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