Combining the Benefits of Collagen and Negative Pressure Wound Therapy to Heal a Chronic Diabetic Foot Ulcer

A Case Report

Jeffrey D. Lehrman, DPM, FASPS, MAPWCA, CPC

Disclosures

Wounds. 2020;32(3):E11-E13. 

In This Article

Discussion

Both collagen dressings and NPWT are commonly used in the management of a wide range of wound types, but little has been documented about their effectiveness when used in combination. A case of combining the benefits of collagen powder and an alternative method mimicking NPWT was reported by Sreelesh and Laxminarayan Bhandari[13] to have beneficial effects; however, to the best of the author's knowledge, this is the first report on the use of a collagen matrix wound contact layer in combination with traditional NPWT methods. In the present case, combining the 2 technologies resulted in timely healing of a chronic DFU, on which multiple advanced treatment modalities (ie, human PDGFs and amniotic membrane allograft) had been attempted previously.

The design of this collagen contact layer makes it particularly well-suited for use on wounds requiring removal of large amounts of exudate, an indication shared with NPWT. The collagen conforms to the wound bed but maintains structural integrity under pressure and over an extended wear time, and the specialized porous design, along with the sodium alginate component, allows for the removal of unwanted fluid from the wound bed into a secondary dressing. When applying NPWT with this collagen contact layer in place, the traditional foam dressing is still able to absorb exudate without coming in direct contact with the wound bed, minimizing any potential for trauma to the newly formed tissues. Furthermore, with its porous design, it is reasonable to surmise this technology may be applicable to a wide range of exuding wounds, such as pressure injuries, leg ulcers, postoperative wounds, and traumatic wounds, which all have indications compatible with the use of collagen dressings.

The present case highlights the use of this collagen with NPWT; however, compatibility with other commonly used treatment modalities (eg, compression therapy) opens up additional opportunities. Further investigation is needed to determine efficacy and investigate the use on different types of wounds and with other medical technologies, such as with single-use portable NPWT systems as they become more readily available. In this case, the technology proved to be a beneficial addition to the care regimen, which achieved complete healing.

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