Safety and efficacy of hydrolyzed collagen in neonatal wounds

Collagen accounts for 30% of the protein of humans and 77% of the skin dry weight. Type 1 collagen is the most common type used in medicine. Collagen preparations enhance proliferative stage of wound repair.  We report on successful neonatal wounds healing with addition of hydrolyzed collagen powder or gel. Hydrolyzed type 1 bovine collagen powder or gel were used to enhance healing of variety of stagnant neonatal wounds. Cases include an infant with large ruptured ankle fibrosarcoma; preterm neonate with a hand wound from severe extravasation; non-healing exudating giant omphalocele wound; neonate with dehisced thoracic wound after congenital heart defect repair,  ulcerated hemangiomas and extremely preterm neonate with peri-ostomy wound dehiscence. 4 patients received powder and 4 received gel.   Antimicrobial skin and wound cleanser were used in all wounds prior to the collagen application and secondary atraumatic dressing was used to cover the wounds. Immunocompromised and critically ill infants and preterm neonates may not posse’s adequate protein and amino acids necessary for collagen formation. Many experience hyperinflammatory response due to overall inflammatory milieu and lack of anti-inflammatory mediators and oxygen radicals’ scavengers. Providing hydrolyzed collagen scaffold likely promoted proliferative healing stage, diminished ongoing inflammation, stimulated fibroblasts and promoted extracellular matrix(ECM) deposition. Our experience supports fast healing response with hydrolyzed collagen, possibly related to small molecular size, therefore ease of tissue incorporation and  bioavailability. All of our cases were challenging in some ways: small physical space, difficult location for dressing application, unfavorable wound bed such as ulcerated, bleeding hemangiomas and immunocompromised patients due to complications of critical cardiac disease and sequelae of cancer. Despite these challenges, all wounds healed completely and timely. No complications related to hydrolyzed collagen application were noted. We recommend considering using hydrolyzed collagen powder or gel in wounds requiring safe, painless and enhanced ECM growth.